MindFreedom Article: "Minnesota mental health patient Ray Sandford
forced into electro-shock therapy"

20 May 2009
BELOW is a *superb* article published in today's "City Pages" about the
ongoing, outpatient forced electroshock of Ray Sandford.
Journalist Matt Snyders expertly walks you through what it is like for
Ray to be woken up in his assisted living home and escorted to another
forced electroshock. The article quotes experts on both sides of the
controversy, and covers the growing international Ray Campaign sponsored
by MindFreedom International.
"City Pages" is the main weekly newspaper distributed throughout
Minneapolis/St. Paul, Minnesota.
Please forward the below article to all interested on and off Internet.
For more info on Ray campaign see:
http://www.mindfreedom.org/ray
~~~~~~~~~~~~
Link to below original City Pages article with photos:
http://www.citypages.com/2009-05-20/news/minnesota-mental-health-patient-ray-sandford-forced-into-electro-shock-therapy
or use this link:
http://tinyurl.com/citypages-ray
~~~~~~~~~~~~
20 May 2009
CITY PAGES - MInnesota
By Matt Snyders
"Minnesota mental health patient Ray Sandford forced into electro-
shock therapy"
Ray Sandford doesn't want to do this.
On a sunny yet cool mid-April morning, the pear-shaped 54-year-old
emerges from the front door of his ranch-style group home in Columbia
Heights. Wearing a black windbreaker and gray sweatpants, he grips the
handle of his four-pronged cane and plods begrudgingly toward the street.
One of Sandford's caretakers, a large woman wearing all purple, follows
perfunctorily behind to see him to his destination.
He's told them repeatedly he doesn't want to do this.
He ambles forward. There's nothing he can do now. No sense in fighting
it. Not now.
A 20-passenger Anoka transit bus idles along the curb awaiting his
arrival. A short, swarthy driver assists Sandford. The bus slowly
pulls away and embarks on the 12-mile ride to Mercy Medical Clinic in
Coon Rapids.
Upon arrival, Sandford walks through the automatic sliding doors and
assumes his position in a wheelchair. He's whisked to a room on the fifth
floor where nurses poke an IV through his fleshy forearm. He's given a
muscle relaxant and general anesthesia. Within 30 seconds, the room
dissolves. He's out cold.
Assistants lay him out on his back. A doctor places electrodes on
either side of Sandford's cranium. Cords extend from the electrodes,
connecting to what appears to be an antiquated stereo set. A couple of
dials protrude from the machine's display. A physician flips an
unassuming switch.
A three-second burst of 140 volts blasts through Sandford's brain.
While he's totally unconscious, Sandford's torso jerks up and down. His
arms and legs writhe only slightly, steadied by muscle relaxants coursing
through his veins. Sandford's toes curl downward, as if his feet were
trying ball up into fists. He's experiencing a grand mal seizure.
Two minutes later, it's over. Sandford will feel a bit woozy the rest of
the day, but there'll be no lasting pain. His short-term memory is the
only thing that will suffer.
But he'll still remember quite clearly that he never wanted to do this.
"They can literally tie me up, put me in ambulance, and bring me in to
get shock treatments," he says. "I don't fight it, because there's
nothing I can do by that time. You want to know how I feel? I don't like
it at all."
 
 
INTRODUCED TO AMERICA in 1939, electroconvulsive therapy is one of the
most controversial medical procedures still in practice. Not much is
known about how or why it works. Even so, by the end of World War II,
every reputable hospital in the world performed the procedure.
"It was a very useful treatment because there was no treatment like it
before," says ECT proponent Dr. Max Fink, widely regarded as the
grandfather of American ECT and a professor of psychiatry at Stony Brook
University in New York. "At the time, every state was troubled by the
fact that they were building bigger and bigger hospitals for the mentally
ill. Once ECT caught on, the number of hospital beds for mental illness
was reduced sharply."
After the advent of psychotropic drugs in the 1950s, however, ECT
appeared to be going the way of the lobotomy. Prescription meds were
suddenly viewed as a more reliable and humane alternative.
But by the early '80s, something unexpected happened: antidepressants and
other psychotropics turned out not to be the panacea everyone hoped they
would be.
"Many doctors had patients who had been given the best care in the
major centers of the world with pills, but they still had patients who
were very, very sick," says Dr. Fink. "So they turned to doctors who were
using ECT devices, and one by one, hospital by hospital, ECT was
reintroduced. Most of the reintroduction occurred at the end of the 1980s
and beginning of the 1990s. By now, there aren't many psychiatric
hospitals that don't have ECT."
Today, between 100,000 and 200,000 Americans undergo the procedure
each year. But not everyone is convinced that's a good thing.
"When you induce a grand mal convulsion by sending 100-plus volts of
electricity in the brain, you're going to create damage," says Dr. John
Breeding, an Austin, Texas-based psychologist and self-described ECT
abolitionist. "This is most easily seen with memory loss that many
patients experience. You're talking major voltage directly into the
temporal lobes of the brain. And the data is very clear that there's
close to a 100 percent relapse rate, which means patients have to keep
coming back and suffer further brain damage. This is referred to as
'maintenance ECT,' rather than as a failed treatment, which is what it
really is."
Even more controversial is the practice of forced, court-ordered
electroconvulsive treatment. Neither the American Psychiatric
Association nor activist groups have estimates on how many Americans
undergo forced ECT annually, but there were 41 cases in Hennepin County
last year.
Ray Sandford was one of them. But unlike the others, he's not going
quietly, opting instead to take his fight to the public arena. A small
army of mental-health activists has now taken up a national-scale PR
campaign on his behalf, painting him as something of a real-life R.P.
McMurphy from One Flew Over the Cuckoo's Nest.
"This case is particularly egregious," says Dr. Breeding. "Ray
Sandford was really the first I heard of somebody being shocked on an
outpatient basis."
 
 
MARILYN SANDFORD had particularly high hopes for her eldest son. When her
three boys, along with their neighborhood friends, would play in a vast
sandpit on the far side of their two-acre estate in Eagan, it was clear,
even from a distance, that Raymond was in charge.
"He was exceptionally bright and had a real gift for verbal
persuasion," says Marilyn. "Those boys were a pack, and he was the
leader of the pack. We assumed he'd make an excellent salesman."
Ray's father, a contractor by trade, built the family's blue two-story
home himself, outfitting the stately split-level with a cathedral ceiling
and spiral staircase. With no mortgage to pay and the postwar housing
boom providing lucrative work for her husband, Marilyn was able to quit
her job as a polio nurse and devote her time to raising the boys.
As Ray entered adolescence, he grew enamored of real estate,
memorizing local lot prices and market fluctuations. His goal, he told
his parents matter-of-factly, was to be a millionaire by the age of 21.
Shortly after Ray's 17th birthday, it became clear that something was
wrong with him. Ray, who had always gotten exceptional grades at Sibley
High in Mendota Heights, suddenly dropped out his senior year. He emptied
his college fund—about $3,000 his parents had saved up—and bought his
own lot in a trailer park in Lilydale, eight miles north.
At first, Marilyn chalked up her son's bizarre behavior to adolescent
angst.
"It's very hard to come to terms with the fact that your eldest and very
promising child is mentally ill," she says. "That's not something you're
ever ready for."
But as Ray's recklessness continued to escalate, Marilyn was forced to
confront reality. Out to run some errands, Marilyn glanced in her
rearview mirror to see Ray following close behind in his '63 Impala—too
close. He whizzed past her, then abruptly stopped. He peeled out around
her, nearly smashing into oncoming traffic, then stopped again.
Ray's thoughts and speech, meanwhile, grew more and more disjointed. When
Ray was 19, Marilyn's father, a country doctor, visited the family. After
supper, he took Marilyn aside and told her what she already knew: "You
need to get that boy checked out."
She brought her son to Hastings Mental Hospital. After observing Ray and
hearing Marilyn's account of his behavior, the doctors gave Marilyn a
grim prognosis: "Your son suffers from severe manic depression. We
recommend he be institutionalized."
Ray's new home would be Hastings Mental Hospital, an austere brick
building.
"Now his brother is a doctor, his sister is a doctor, another brother is
a successful engineer, and then another brother owns and manages
property," Marilyn says ruefully. "They're all doing very well and here
he is, the leader—and each hospitalization leaves him a little less
well-off financially. So now he really has nothing."
In 2005, Marilyn, then 76 and eying her own mortality, contacted
Lutheran Social Services, the state's largest nonprofit provider of
health care, and asked them to act as legal guardian and caretaker for
Ray. She would no longer have any legal say in his future. For Marilyn,
it was a difficult but necessary decision.
"I have high blood pressure; I could die tomorrow," she says. "It's
ridiculous to assume I could be responsible for someone else's life at
this point. I knew we needed to find him a conservator."
By 2006, Ray Sandford had transferred to Community Behavioral Health
Hospital in Willmar. Shortly after the move, his manic spells worsened.
Sandford grew frustrated with the confines, which only exacerbated his
psychosis. According to a report later submitted to a mental court,
Sandford was "grossly psychotic, yelling violently and smearing feces all
over, urinating wherever and whenever he felt like it."
The meds weren't working. The time had come for an alternative.
In January 2008, staff at Willmar approached Dr. Kevin Turnquist, a
psychiatrist who specializes in schizophrenia. Four months after meeting
Ray, the doctor petitioned to impose electroconvulsive therapy on the
54-year-old.
At the May 13 hearing in the basement of St. Paul's Regions Hospital,
Ramsey County District Judge Teresa R. Warner heard from Dr. Turnquist,
as well as from two court-appointed medical examiners who testified that
Ray was "not in a position to weigh the benefits versus the risks of ECT
treatment."
The hearing was quick, lasting barely a half-hour.
"The Court considered the respondent's family and community, as well as
his moral, religious, and social values," ruled Judge Warner. "Based on
these considerations, a reasonable person would authorize treatment with
electroconvulsive therapy."
 
 
THE RITUAL always begins the same.
Just after 6 p.m. Sandford hears a knock at the door. It's his
caretakers. They've come to raid his refrigerator.
"No more food for the rest of the night, Ray. Doctor's orders."
After purging the fridge of sandwich meat and the shelves of Doritos,
they march upstairs and stash the provisions in a padlocked compartment.
It's not a cruel trick; if Sandford ever succumbed to a midnight
hankering for a bologna sandwich, it might very well prove to be his
last. That's because, should any food still be sloshing around his
stomach during next morning's ECT-induced seizure, there's a good chance
he'd vomit and choke to death on the table.
Which is why he doesn't utter a word of protest as they carry his
groceries away, or when his stomach starts growling at 10 p.m.
"There's nothing fun about it," he says of the fasting, and leaves it at
that.
Of greater concern to him is the procedure itself. He knows he'll be
unconscious during the ordeal, that it will be painless. Still, he's a
bit anxious.
"You don't know if you're going to wake up," he says, his eyes
widening as he confronts his own mortality. "It's not very likely, but
it's still possible. When I did the first couple of them, I was a lot
more scared than I am now."
He did those first few willingly—anything to get out of the
hospital, which he found to be oppressive. It seemed like a fair trade-
off.
But on June 10, 2008, he once again found himself in the basement
courtroom of Regions Hospital listening to important strangers explain to
other important strangers why it's in society's best interest to blast
140 volts of electricity through his cranium at regularly scheduled
intervals. Today's hearing would decide whether the month- long court
order should be allowed to expire.
One of the strangers, Dr. Peter Myers, whom Sandford had met only
briefly, testified that Sandford had shown "noted improvement" since
beginning ECT, in the sense that Sandford "now has the ability to remain
calm." Dr. Myers also commended him for "exhibiting more organized
thought patterns." However, continued the doctor, "he still remains a
danger to himself and is in need of continued commitment and treatment
with neuroleptic medication and electroconvulsive therapy."
Judge Warner agreed. She gave the go-ahead for three ECTs a week for up
to four weeks, followed by one treatment per week for one year
thereafter.
The ruling was based on solid precedent. In 1976, just as ECT was at the
nadir of its popularity, a 14-year-old Minnesota boy was shocked against
his and his mother's objections. The mother filed suit and went before
the Minnesota Supreme Court. The resulting decision held that legally
competent patients were immune from being shocked against their stated
objections. Moreover, the case made clear that even incompetent patients
were entitled to a court proceeding before being administered
electroconvulsive therapy.
On its face, the Price-Sheppard decision appeared to bolster patients'
self-determination—after all, the requirement for guardians to get
court-approval before administering the volts is one that didn't exist
before.
But in practice, court-ordered ECT has been on the rise since the
ruling, for a number of reasons. The ruling assumed that a committed
person is—by very virtue of being committed—incompetent. Second,
attaining the court order is more of a bureaucratic formality than a
serious deliberation.
"I would say the court grants the order for ECT in well over 90
percent of the cases," says Doug McGuire, of the Hennepin County
Commitment Defense Panel, which represents patients in the
proceedings. "It's very unusual for the court not to grant the ECT
request."
Mental health courts require a lower standard to the petitioner
("clear and convincing evidence") than do criminal courts ("beyond a
reasonable doubt"), but more importantly, the petitioner—almost
invariably a doctor, as in Sandford's case—naturally wields more
credibility than a person deemed unfit to care for himself.
"One of the issues that comes up is how vigorously the person's court-
appointed attorney puts forth their objections to the ECT," notes Pamela
Hoopes, the lead attorney for the Minnesota Disability Law Center.
 
 
ON OCTOBER 22, David Oaks was sitting in his office in Eugene, Oregon,
when his phone rang.
As director of MindFreedom International, a coalition of self-
described "mental human rights organizations" advocating what they
call "a nonviolent revolution in mental health care," Oaks has fielded
his share of strange calls. But Oaks had never heard a story like this
before.
"My name is Ray Sandford," said the man on the phone. "I live in a
group home in suburban Minneapolis. I'm getting electroshock treatment
against my will. What do I do?"
Oaks dialed Lutheran Social Services to confirm the story. A worker
familiar with Sandford's case verified that Sandford was indeed receiving
court-ordered electroshock treatments. A copy of the court order
confirmed it.
"I get calls all the time from people who are frightened, who are
being pushed around and bullied by the mental health system," says
Oaks. "But this guy has made sense the whole time. His was an
extremely human response: 'I don't want it.'"
Taking up the cause, MindFreedom launched an online Campaign for Ray,
with a website detailing Sandford's predicament. Oaks compiled a list of
caretakers associated with Sandford—from doctors to judges to
lawyers—along with their contact information, encouraging visitors to
call them and demand they put an end to the treatment. In addition,
MindFreedom sent out mass emails to its network of activists who, in
turn, inundated the governor's office with phone calls.
The tactic seemed to be working. On April 15, Dr. Dean Knutson stepped
aside as Sandford's psychiatrist. Eight days later, Lutheran Social
Services submitted to the Ramsey County probate court a petition to
resign as Sandford's guardian.
But on May 12, a knock sounded outside Sandford's door. It was his
caretakers. They had come to raid his refrigerator.
 
 
THE NEXT DAY, Sandford emerges from his front door to a familiar
sight: an idling white bus. He slowly steps forward, his four-pronged
cane gripping warm asphalt.
He doesn't want to do this. He's told them repeatedly he doesn't want to
do this.
He climbs inside the bus and takes a seat. A hiss sounds as the bus's
brakes release.
He arrives at Mercy Medical Clinic and is taken to the fifth floor. An IV
is inserted. Sandford is less than two minutes from undergoing his 43rd
ECT when a doctor approaches him.
"Mr. Sandford, it looks like we're going to postpone today's
treatment," he says. "Sorry for the inconvenience."
Unbeknownst to Sandford, his mother had, for the past 48 hours, placed
dozens of calls to Mercy's ECT Unit. Her words were concise and
persuasive.
"His doctor has given up on him," she told anyone who would listen. "I'm
a retired nurse. And I know for a fact you cannot give ECT without a
doctor's order."
It's unclear whether Sandford will have to go through with more ECT or
who his new doctor will be. Marilyn and a friend are in the process of
finding a psychiatrist.
As for Ray Sandford, his appraisal of last week's surprising turn is
characteristically nonchalant.
"I felt a whole lot better after they told me I wouldn't have to go
through with it," he says. "But I wish they would have told me earlier,
instead of having to go through all the trouble. They knew I didn't want
to do this."
- end -
~~~~~~~~~~~~~~
* ACTION * ACTION * ACTION *
*FORWARD* this important article to those interested far and wide on and
off Internet, now!
*THANK* City Pages for its journalism via this web page:
http://www.citypages.com/feedback/add/924202/
*LEARN* about Ray Campaign and find out how you can help here:
http://www.mindfreedom.org/ray
*SUPPORT* MindFreedom by joining, donating, renewing early here:
http://www.mindfreedom.org/join-donate
~~~~~~~~~~~~~~
IN OTHER NEWS....
MindFreedom co-sponsored successful protests directly in front of the
American Psychiatric Association huge Annual Meeting in San Francisco on
17 May and 18 May 2009. In a guerilla theater "screening for normality,"
hundreds of flyers were handed out about Ray to participating
psychiatrists.
For article and photos go to:
http://www.mindfreedom.org/apa
~~~~~~~~~~~~
It's logical!
*IF* It Takes United People Power to Change the Mental Health System...
*THEREFORE*... Let's All Support MindFreedom International!
Now, as never before!
MindFreedom International is one of the few totally-independent,
action-focused nonprofit organizations in the mental health advocacy
field, with zero funding from the mental health system, governments, drug
companies or religions.
That means YOUR membership and donation are CRUCIAL to MindFreedom
International's campaigns for human rights alternatives.
Join or donate now:
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Times are tough, so that makes it even more important that each and every
person give what he or she can.
Benefits include MindFreedom Journal, special web and e-mail
networking, discount on http://www.madmarket.org  purchases,
MindFreedom Shield, member services office... and a nonviolent
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Donate, join now or renew early here:
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~~~~~~~~~~~~
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