LOS ANGELES PUBLICATION INVESTIGATES
PSYCHIATRIC HUMAN RIGHTS VIOLATIONS OF YOUTH, IN ARTICLE PUBLISHED YESTERDAY
ACTION: Thank publication with letter to editor
Below is an article published in _New Times LA_
Nov. 16, 2000. It blasts the psychiatric human
rights violations experienced by youth in the Los
Angeles Metropolitan State Hospital. The article
tells the story of one youth in particular.
Ted Chabasinski, president of Support Coalition
International, is quoted several times. Board member
Loren Mosher, MD is quoted. Other members -- such as
Peter Breggin, MD and Fred Baughman, MD -- are also quoted.
The paper's web site for the below article has photos --
click on the page numbers at the bottom of their web
site for more photos, including of Ted and Peter.
ACTION:
1. PLEASE REDISTRIBUTE THIS HUMAN RIGHTS ALERT
to all appropriate places on and off the Internet.
2. PLEASE CONSIDER A LETTER TO THE EDITOR
to thank the publication for this article. _New Times LA_
states that it has a circulation of more than 120,000.
E-mail to: editor@newtimesla.com
If you wish, copy your letter-to-the-editor to Support
Coalition at: office@MindFreedom.org
3. THE NEXT ISSUE of Support Coalition's publication
_Dendron_ will be about youth and psychiatric human rights violations. If you are not yet a member and want to get
Dendron #44, then e-mail your postal mailing address to: office@MindFreedom.org
. For more
info on Support Coalition International see http://www.MindFreedom.org
.
ARTICLE -- Originally published by _New Times Los Angeles_
November 16, 2000
©2000 New Times, Inc. All rights reserved.
{ http://www.newtimesla.com/issues/2000-11-16/feature.html/page1.html
}
A Terrible Thing to Waste
This boy has taken psychiatric drugs for years while
in L.A. County's care.
His family and some doctors say he's become a zombie.
By Susan Goldsmith
Johnny Mack Dixon, chubby cheeked and three years
old, pushed hard on the screen window in his South
Central apartment. He was a curious little boy who,
like other toddlers his age, loved to explore
everything he came across. His mother, distracted,
was putting his little brother Leon to sleep on a
couch nearby. Before she could do anything about it,
the screen gave way and Johnny tumbled out the
third-story window. He plunged to the ground below,
hitting with a loud thud that horrified neighbors.
Someone called an ambulance. Johnny's mother grabbed
the baby and ran downstairs screaming. Amazingly, her
son wasn't unconscious or even bleeding. He was alert
and trying to get up. His mother and some neighbors,
uncertain if he had broken any bones, held him down
until the paramedics arrived. At a nearby hospital,
doctors examined the toddler and declared him a
small miracle. He had survived the fall with only a
few scratches.
It was the only lucky break Johnny Mack Dixon ever
got.
Johnny was born in 1989 to a 17-year-old welfare
mother who later became a crack addict. Although
Swania Hogue had graduated from Los Angeles High
School, she couldn't read or write. A tough, lean
girl with 14 gold hoops hanging from each ear, she
was as unprepared for adulthood as she was for
motherhood.
Her maternal instincts came and went as
unpredictably as a teenager's bad moods. Twice she
went to jail for smoking crack -- once for several
months -- leaving Johnny and his brother in the care
of their grandmother. The boy's father, also named
Johnny Mack Dixon, was a six-foot-five-inch bank
teller with a rap sheet for selling narcotics,
battery, public fighting, and soliciting a
prostitute. The couple split up when Johnny was
five. Today, Johnny senior is in prison in Ohio for
bank robbery, and has not spoken to his son in
several years.
A new man entered little Johnny's life a couple of
years after his father left California. Lucky Clark
was a crack addict whom Johnny's mother met while in
drug rehab, court records show. Thin and well
dressed, Clark worked in a warehouse and had several
convictions for burglary.
Clark, too, proved a poor parent. He sold the
children's food for drugs, according to Johnny's
grandmother Kathryn Winzer. Johnny later told social
workers Clark also whipped him all over his body with
a belt when he misbehaved. Leon said he was beaten,
too.
Even at his beloved grandmother's house, where
Johnny feasted on homemade pot pies and fried
chicken, there was no refuge. There, his maternal
uncle, Donald Hogue, unleashed an explosive anger on
his raspy-voiced nephew. When Johnny got into
mischief, social workers alleged, his uncle punched
and kicked him, and slammed his head into the
refrigerator. Uncle Don-Don, as Johnny called him,
is now in Pleasant Valley State Prison in Central
California for robbery.
Johnny "is a sad, lonely, and empty little boy with
a great many liabilities and very few assets," one
psychologist wrote after evaluating him. "It appears
he has not benefited from very many of the pleasures
life has to offer."
When Johnny was old enough to attend elementary
school, his troubled home life began manifesting
itself in the classroom. He had wild outbursts and
couldn't concentrate. When school officials
recommended that he not live at home anymore, his
mother agreed. She turned Johnny, then eight, over
to a home for troubled children run by L.A. County.
Today, his situation is even more dire. Now 11,
Johnny is locked up in the children's ward at
Metropolitan State Hospital in Norwalk. It is a
mental institution, a One Flew Over the Cuckoo's
Nest sort of place with isolation rooms, beds
equipped with leather restraints, and a drab day
room with an old television that is always on. And
his family say they barely recognize the bright boy
who loves to wrestle.
Given a combination of powerful psychiatric drugs by
government doctors, Johnny seems like a zombie, his
relatives say. He often drools, seems sleepy and
disoriented much of the time, and urinates on
himself at night. His face is covered with a
drug-induced rash. In the last four years, he has
been on at least 15 psychiatric medications, most of
which have never been tested on children and some of
which are not even approved for psychiatric purposes.
During a recent interview at the hospital, the boy
was asked about the drugs he's on. His eyes half
shut, sounding like a drunk, Johnny pointed at the
window and blurted, "Look, doughnuts!" A few
minutes later he was asked the same question. As a small rope
of drool slid from his open mouth, he said,
"Yesterday I was crying and tired because they said
"Take a shower,' and I couldn't take a shower
because I was falling-down tired."
According to Johnny's medical records, which New
Times obtained, a county psychiatrist who is
treating him believes he is severely mentally ill --
a danger to himself and others -- and needs heavy
medication to keep his unpredictable and frightening
mood swings in check.
But outside mental-health experts who reviewed some
of Johnny's records at New Times' request say he has
deteriorated badly in county care and is the victim
of a dangerous, four-year pharmaceutical onslaught.
"A horse couldn't function on the drugs this boy is
on.... He's at risk for permanent neurological
damage," says Dr. Peter Breggin, a Maryland
psychiatrist who has authored several books about
psychiatric medications, also known as
psychotropics, and who heads the International
Center for the Study of Psychiatry and Psychology.
"He's got two abusers: abuse at home and psychiatric
drug abuse."
Johnny is among scores of children at Metropolitan
State Hospital to whom psychotropic drugs are
administered. Like Johnny, many of the kids, who
range in age from 10 to 17, are minorities. Of the
103 children confined at the hospital, 90 are given
psychiatric medications.
"You're putting a foreign substance into a child's
body, and every drug is potentially a poison, and
these doctors don't know how these drugs will affect
these kids," says Dr. Paul Fink, former president of
the American Psychiatric Association. "When drugs
are given to children, doctors try to cut the doses
down, but there is no science to it."
Johnny's family can do little to help him, and
county social workers warn he'll probably remain at
Metropolitan until he is 18. His mother isn't even
capable of reading his medical records. In a burst
of outrage, Winzer, a feisty woman who is the
family's life raft, wrote a letter about Johnny's
medicated stupor and mailed it to Cal-OSHA, the
state's workplace safety agency. Cal-OSHA looks
after workers on the job, not 11-year-old boys in
mental hospitals. Winzer got no response.
"I've been so surprised his heart didn't just
collapse from all he's being given," says Winzer, a
Metropolitan Transportation Authority stenographer.
"I tell the social worker and he just looks at me
with a questionable look, like I'm not that high up
of a person to be questioning him on that."
The social worker's blank stares and the lack of a
reply from Cal-OSHA have left Winzer wondering how
she and her daughter can help Johnny. All she can
think of is to tell her grandson to drink plenty of
water, in the hope of diluting all those pills in
his growing body.
Johnny Mack Dixon's journey to Metropolitan State
Hospital was filled with well-intentioned people.
From his records, it's clear that county
therapists,
psychiatrists, and social workers all wanted to see
the damaged little boy flourish. They wrote lengthy
reports about his psychological problems and what
treatment would best suit him. "Johnny needs to
continue in long-term therapy to work on processing
and expressing his feelings of anger and depression
relating to the severe abuse he endured.... He is a
fragile, angry, and depressed young boy," one social
worker wrote in 1998. Wrote another: "He continues to
express worry that the judge "will make him go home
now.' He continues to express that if he goes home
he will continue to get whippings and be unsafe....
It is going to be an extremely slow process for
Johnny to begin to resolve the issues regarding his
traumatic past."
Social workers also found things to praise in
Johnny, who, despite his profound behavioral
problems, is a talented athlete who can be playful
and affectionate. "Johnny has been able to form
positive relationships with certain staff," one
report said. "His strengths include that he is
bright, has good verbal skills, and enjoys art."
Yet despite the compassionate tone of the reports,
Johnny has hardly blossomed under government care.
He went into the county foster-home system as an
angry, out-of-control boy. Today, the fifth grader
is locked up like a prisoner and has difficulty
staying awake and thinking or speaking coherently
because of the multiple medications he takes.
At times, he can follow a conversation and is warm
and thoughtful. But those moments are the exception.
Much of the time, Johnny babbles incoherently,
abruptly stops talking in mid sentence, and
hallucinates.
During an interview with a reporter at the hospital,
he struggled to keep his eyes open, slurred his
words, and couldn't answer most questions. Asked how
the hospital was different from the county home where
he had been the previous four years, Johnny stared
into space for several seconds and appeared as if he
was going to nod off. Then, he began talking but made
little sense. "Miss King shout at us. When I say,
"No, you didn't shout at us,' she say, "Go take a
time-out,' and I say, "No! Why should I? Wash your
mouth!'" In response to a question about the drugs
he takes, Johnny dazedly answered, "I'm scared of It
the Clown. He kills kids."
Johnny's problems first came to the attention of
outsiders during his elementary school days in
Duarte. The little boy with the almond-shaped eyes
and dazzling white teeth was hyperactive and had
serious behavioral difficulties in the classroom. He
hit, kicked, and bit other students, talked about
wanting to kill himself, and had intense,
unpredictable mood swings. Doctors put him on
Ritalin for his hyperactivity, but the drug did
little to calm him, records show. School officials
noted that when he came back from living in Long
Beach with his mother and Lucky Clark, his behavior
deteriorated even further. In a 1996 evaluation,
school officials described Johnny as so emotionally
disturbed that they simply could not deal with him.
They recommended that he be put in a county
residential facility for behaviorally troubled
children. Johnny's mother -- who had had a third
child that year by a man she dated briefly -- was
overwhelmed by parenting and trying to deal with her
crack addiction. In 1997, she consented to put Johnny
into Hillsides, a county facility in Pasadena for
very disturbed youngsters. The home has 100 boys and
girls, aged 6 to 17.
Shortly after arriving at Hillsides, Johnny, then
eight, began telling horror stories about his past.
He described how his uncle and his mother's
boyfriend beat him. He talked about being molested
by two older girls in his rough Long Beach
neighborhood, where gunfire and drive-by shootings
were frighteningly common and, court records show,
his mother's boyfriend got into terrible fights.
(Following Johnny's disclosures social workers
investigated the family and removed Swania Hogue's
two other children from her home and placed them in
foster care, where they remain today. In addition,
Johnny was put under the legal control of the county
Department of Children and Family Services, although
his mother and grandmother are allowed to visit him
regularly.)
Johnny made connections with some of the staff, but
his transition to life at Hillsides was not smooth.
When he became angry, he tripped a Hillsides staff
member, hurled himself on the floor, ripped off his
clothing, threw furniture, banged his head, and
attempted to expose himself. In class, he lashed out
at other students, threw things across the room, and
had difficulty paying attention.
According to medical records, the boy was
diagnosed as suffering from attention deficit/hyperactivity
disorder and bipolar disorder (also known as manic
depression) shortly after arriving at Hillsides. It
was then that he became the target of a veritable
deluge of pharmaceuticals under the direction of a
staff psychiatrist. It is not clear if some of
Johnny's behavioral problems were exacerbated and
others created by the powerful drugs he was given.
Within weeks of his arrival, Johnny began taking a
laundry list of medications, some of which were
started, then stopped, then started again when he
developed side effects including dizziness, nausea,
lethargy, and body tremors. The staff psychiatrist
put him on Tegretol, an anticonvulsant that acts as
a mood stabilizer; Dexedrine, an amphetamine used to
treat hyperactive children; and lithium, a powerful
mood-altering agent. The psychiatrist also kept
prescribing Depakote, an antimanic drug, which
Johnny had been put on before arriving at Hillsides.
Over the next several months, three different
antipsychotic drugs were tried, and the boy was put
on a second medication for mania.
But instead of improving, Johnny deteriorated, which
independent experts say was probably a response to
his heavy drug regimen.
He started washing his hands obsessively, sometimes
10 to 15 minutes per washing. He threw tantrums if
he found a speck of dirt on his clothing, sat for
hours repeating the same thing until he worked
himself into a frenzy, and often refused to eat.
According to notes in his records by a Hillsides
staff member, the medications caused hand, head, and
body tremors and other problems, including drooling,
lethargy, nausea, dizziness, and rigidity in his
hands. At one point, he was "too sleepy" to stand
up. The staffer wrote that he "appears very
lethargic, difficult to communicate with, attempted
to set him upon edge of bed, he was shaky and tipped
over."
When contacted by New Times, the staff psychiatrist
refused to comment on Johnny's care, citing state
confidentiality laws. He also declined to comment on
his general approach to medicating children.
Because of Johnny's adverse reactions to the
medications, another psychiatrist was brought in to
review them. That doctor deemed the drugs
appropriate. But the consulting psychiatrist
recommended that the boy be hospitalized and
switched to a different antipsychotic medication,
since the one he was taking caused involuntary
muscle contractions.
In May 1998, Johnny was placed in a psychiatric unit
at Las Encinas Hospital in Pasadena for six days.
When he returned to Hillsides, he was put on yet
another cocktail of medications, records show. By
July 1998 -- 10 months after being sent to Hillsides
-- Johnny had been on 11 different psychiatric drugs
in various combinations.
"Those medications just made him talk
incoherently.... He would drool and was sleepy all
the time," Kathryn Winzer recalls from her visits
with her grandson at Hillsides. "They had him
looking like he was really crazy, and that wasn't
right."
Johnny's behavior became more bizarre. In the
ensuing months, staffers noted that the little boy
was doing alarming and dangerous things. He
hallucinated, had delusions, stuffed a bedspread
down his throat in an attempt to choke himself,
pulled out some of his eyebrows, wet his fingers and
stuck them in electrical sockets. He bit himself, and
on one occasion declared "I want to die" and ran
into the path of an approaching car. A Hillsides report
last January said he was hearing voices, eating
rocks and sand, had swallowed a toothpick, and had
tried to poke his eye out with a fingernail.
"The use of all these drugs is a psychiatric and
medical assault on this child," says Dr. Fred A.
Baughman, a pediatric neurologist from San Diego who
has authored numerous articles decrying the absence
of any scientific studies of child psychiatric
disorders. He recently testified before a
congressional subcommittee on the issue. "Psychiatry
has no idea how one of these drugs affects a kid's
brain, let alone a combination of them. These are
poisoning and intoxicating. I think it's perfectly
understandable to suggest he's been made crazy from
all these drugs."
While Johnny has been labeled with various
psychiatric diagnoses, such as bipolar disorder and
childhood schizophrenia, Baughman is skeptical of
them.
"Psychiatry claims every one of those disorders and
diseases are due to chemical imbalances in the
brain, and yet there is no science whatsoever to
back that up," he says. "Every one of those
diagnoses is used to create a justification for a
prescription."
Julie Zito, a professor of pharmacy at the
University of Maryland who has studied the use of
stimulants and antidepressants in children, said
research has shown that children in the foster-care
system are 3 to 10 times more likely than youngsters
in the population at large to receive a diagnosis of
mental illness. "We could be doing better work
monitoring drug protocols of kids in foster care,"
she says.
As Baughman and other doctors point out, many of the
medications Johnny has been put on have never been
studied in children, and physicians have no idea
what dosage is appropriate nor how the drugs will
affect a child's developing body.
"We don't know the proper dosage for someone who
weighs one-quarter of what the average person who
takes the medication weighs," says Fink, the former
American Psychiatric Association president. David
Cohen, a professor of social work at Florida
International University who studies differences
from country to country in the use of psychiatric
drugs on children, says doctors are reduced to
guesswork in trying to determine the proper dosage
for children. "You know what the drugs do for
adults, so you just lower it for kids. It's a
crapshoot," says Cohen, who recently coauthored a
book with Breggin about the dangers of psychiatric
drugs and how to withdraw from them safely.
Furthermore, Fink and others point out, using drugs
not specifically approved for psychiatric purposes
-- a number of which Johnny has been prescribed
while under government care -- is quite risky, since
no studies of their effects on children exist.
Because there aren't drugs for every psychiatric
condition, Fink says, doctors sometimes experiment
with medications normally used for nonpsychiatric
disorders. The practice, known as using drugs
off-label, is based only on anecdotal evidence that
they are effective against a psychiatric malady.
"You have to figure out what to do and you
experiment. It's a single-person experiment, and you
have to be careful," says Fink. "Using drugs
off-label should be done with extreme care."
Using drugs off-label is perfectly legal. The
federal Food and Drug Administration approves
medications for certain symptoms, but physicians are
free to use them in any way they see fit. "The FDA
approves a drug for safety and efficacy, but we have
no authority to regulate physicians and the practice
of medicine," says FDA spokeswoman Laura Bradbard.
"If someone discovers that a particular chemical
helps in another way [not indicated on a drug
label], that's beneficial."
But Zito, the University of Maryland pharmacy
professor, says there is often little research to
justify off-label prescriptions.
"My biggest concern is the evidence is not strong in
the off-label use of these drugs, particularly when
the meds are combined in multiple drug regimens,"
she says. "Without close monitoring, you don't even
know whether you're going to pick up behavioral
toxicity -- a new psychiatric symptom attributable
to the medication rather than the child's illness."
Drugs are rarely tested on children for ethical
reasons. As a result, doctors often use adult
medications on younger patients after hearing that
they have useful side effects. For example, one of
the medications Johnny was prescribed is Clonidine,
which is usually employed to treat high blood
pressure but which also acts as a sedative.
According to Cohen, doctors saw how Clonidine made
adult patients lethargic and deduced it might have
the same effect on hyperactive children.
"A doctor tries something once, publishes a case
study. Someone picks it up, talks about it at a
conference, and then everybody starts using it,"
Cohen says.
While in the county's care, Johnny has been on at
least three medications that were not approved for
psychiatric purposes.
For much of 1999 and early 2000, the boy was
hospitalized in the psychiatric wards of various
private hospitals. By spring, county officials
decided the best place for him was Metropolitan
State Hospital, where he was moved in August and put
on yet another group of medications, including
Clozaril, an antipsychotic drug so toxic that it has
caused a number of deaths and been banned in several
European countries.
After reviewing Johnny's records, Breggin, the
Maryland psychiatrist, said many, if not most, of
his problems, such as obsessive-compulsive and
self-destructive behavior and hallucinations, were
almost certainly the result of his medications.
"These drugs can make you psychotic. These doctors
are experimenting on this child. It's dangerous,"
Breggin says. "There are no kids who need drugs like
this.... When you impair brain function with multiple
drugs, you increase the emotional instability of the
child."
In Breggin's view, many of Johnny's early problems
were probably the result of the Ritalin he took in
grade school. The psychiatrist says a study
published in the Canadian Journal of Psychiatry last
year found that 11 percent of children on Ritalin
developed psychotic symptoms.
Breggin says Johnny doesn't need drugs or
hospitalization. Instead, the psychiatrist explains, he should be in a foster care home that offers him
therapy as well as plenty of love, attention, and discipline.
"You have to get this kid away from these
doctors," he says. "He is legitimately outraged about his
family, and instead of dealing with that, they are drugging him into submission."
Metropolitan State Hospital looks like exactly what
it is: an aging mental institution.
Built in 1916, the hospital sprawls across 162
grassy acres in suburban Norwalk, south of downtown
L.A. The grounds are dotted with numerous
Tudor-style buildings and several newer, drab
one-story facilities. Walls and fences separate the
hospital from the surrounding community, and guards
patrol its entrances. It is the last state mental
hospital in California with a wing for children and
teenagers. Of the kids now there, 69 percent are
black, Latino, or Asian. It costs taxpayers $118,000
per year to care for each child at Metropolitan.
The hospital houses children from all over the
state, but a large majority of them -- 77 -- are
from L.A. County. Ninety percent of the hospital's
young patients take psychiatric medications, but
state mental-health officials refuse to identify
those drugs to New Times.
The high cost of treating a child at Metropolitan is
not reflected in the physical surroundings. The ward
that houses the youngest children -- including
Johnny -- is a prisonlike place with long,
linoleum-lined hallways, bright fluorescent lights,
and lots of locked doors. The kids spend much of
their time in a large day room that has several
chairs and an old TV set but nothing else. Off the
day room is a concrete recreation area with
bolted-down metal picnic tables, benches, and a
basketball hoop. Children also attend school at the
hospital, but just how much they are absorbing is
unclear.
"When you go into the school on hospital grounds, as
I have, you see that half the kids are unconscious,"
says Melinda Bird, an L.A. attorney who specializes
in helping the disabled and has filed a lawsuit on
behalf of children at Metropolitan. "They're just
completely zoned out, heads lolled over, visibly
overmedicated and disoriented."
Bird has also observed during her visits that
youngsters are often given even more medication when
they misbehave, and "any sign of rebellion results in
kids being restrained." During two of a reporter's
four visits with Johnny, someone on his ward was
being strapped into a restraining bed in an
isolation room. A child's wrists, ankles, and waist
are strapped down with leather restraints so he or
she cannot move on the bed. State records show
restraints were used on children at the hospital 151
times in September.
The hospital reopened its children's ward in 1997 --
the first time in two decades -- after Camarillo
State Hospital closed down and Napa State Hospital
shuttered its children's unit. Almost immediately
after Metropolitan began accepting children again,
Ted Chabasinski, an employee of the state Office of
Patients Rights who was briefly stationed at the
hospital, wrote a scathing critique of conditions
there and quit his $33,000-a-year job in protest.
"It's a garbage dump for children where they are
being loaded with drugs," says Chabasinski, who
himself was locked up in a state mental institution
in New York for most of his childhood. "One of the
reasons I'm sitting here today and talking
coherently is because they didn't have those drugs
when I was in the hospital."
Metropolitan, he says, is a place that offers
children nothing but "drugs and despair." While
monitoring the hospital for the state
patients-rights office, Chabasinski saw children in
very bad shape -- not because of their own mental
problems but as a result of the terrible environment
and the treatment they were receiving, he contends.
"They're locked up like maximum-security prisoners,
with their minds dulled with drugs for years on
end," he says. "You see these kids, and they've
just given up on life."
Chabasinski, now a Bay Area attorney who specializes
in the rights of the mentally ill, knows what such a
place can do to a child. He was a patient in New
York state mental hospitals from the age of 6 until
he was 17. He was put in foster care just 10 days
after he was born in 1937, he says, because his
mother was mentally ill and shut away in a state
hospital. Social workers decided that Chabasinski, a
shy, quiet child who preferred reading to playing
with other children, was mentally ill as well, even
though, he says, he did nothing to encourage that
conclusion.
At Rockland State Hospital in Orangeburg, N.Y.,
doctors diagnosed him as having childhood
schizophrenia and began giving him shock treatments.
He describes life in the hospital as Dickensian; he
often was dizzy and exhausted from the shock
treatment, and spent entire days alone rocking on
his mattress, crying and wishing he could see his
mother. Doctors thought fresh air was good for the
patients and left the windows open even in winter,
so he had terrible colds that lasted for months. He
finally walked out of the hospital at 17, after
doctors determined he was ready to leave.
Today he is a graying 63-year-old who resembles a
college philosophy professor. His glasses are a bit
cockeyed, he carries a small, worn nylon backpack,
and his clothes are gently rumpled. Talkative and
very open about his life, he says his sense of self
was badly damaged by his years in the mental
hospital. "You have this constant message you're
worthless, you're subhuman, and nobody cares about
you.... They indoctrinate you with self-hatred."
Chabasinski thought his life's work helping mental
patients and his own sad childhood were fusing into
an important mission when, in 1997, he quit his job
and spoke out before the L.A. County Board of
Supervisors about conditions for children at
Metropolitan State Hospital. But his protests made
no difference.
"I was totally ignored when I spoke at the L.A.
County Board of Supervisors," he says. "They cut
off the microphone."
A year later, a mental-health advocacy group and
three public-interest law firms based in Los Angeles
tried to do something about conditions for kids at
Metropolitan. They filed a class-action lawsuit on
behalf of several youngsters there, arguing that
federal law requires states to provide free
"preventive and rehabilitative" mental-health
services to low-income individuals under 21 with
psychological problems. (The suit was later expanded
to include children from all over the state with
psychiatric problems.)
The lawsuit claimed that under the federal Medicaid
program, such children were entitled to what's known
as therapeutic behavior services but were not
receiving them. Therapeutic behavior services, which
are intended to help children stay out of
institutions, include comprehensive mental-health
assessments, a behavioral aide who accompanies and
mentors the child several hours a day, family
counseling, and transportation to needed services.
The public-interest attorneys alleged that L.A.
County had failed to develop therapeutic foster-care
homes for those youngsters unable to return to their
families, and had no appropriate programs for those
who could go home -- both of which the law required.
"We felt this level of institutionalization [at
Metropolitan State Hospital] was unnecessary for
these kids and these community-based alternatives
had not been tried," says Melinda Bird, one of the
lead attorneys on the case.
Bird says therapeutic behavior services can cost
less than institutionalizing a child at
Metropolitan, but the exact cost depends on what
services that youngster receives.
In response to the suit, a federal judge issued an
injunction last May ordering the state Department of
Mental Health and all counties to implement
therapeutic behavior services for eligible children.
But Bird contends L.A. County is lagging far behind
other counties. To date, no child has been released
from Metropolitan, and only 70 out of 110 eligible
children in other county mental-health facilities
have received the services. "There are lots of
different ways to implement therapeutic behavior
services, and L.A. County has chosen a way that is
extremely slow," she says.
County officials dispute Bird's contention that they
are moving too slowly. A therapeutic services program
"is up and running," says John Hatakeyama, deputy
director of the L.A. County Department of Mental
Health and the man in charge of implementing the new
program. "Kids appropriate for these services are
receiving them."
Besides Metropolitan State Hospital, L.A. County has
a network of homes, like Hillsides, for mentally ill
and behaviorally troubled children. Some of those
homes are now offering the services required by the
lawsuit, Hatakeyama says.
Asked if any children at Metropolitan will be
transferred home or to less restrictive settings, he
says, "We're always looking at kids at Metro to
determine if they no longer require that level of
care.... Whether those kids should be there has been
reviewed."
Bird insists that at least some of the kids at
Metropolitan should be released. "Metro staff do the
evaluations," she says, "and they have an
institutional perspective which is totally at odds
with the therapeutic behavior services/community
integration approach." She plans to ask the judge to
appoint an independent evaluator for the kids at the
hospital.
Bird's suit may or may not help Johnny Mack Dixon.
Social workers say he's likely to remain at
Metropolitan until he's 18. Swania Hogue and Kathy
Winzer are deeply upset by the idea that he'll spend
so much of his childhood in a mental hospital.
"It's not a good place for a kid to be unless they
kill somebody or slice their neck," says Hogue, who
tries to visit her son weekly, taking a bus and then
a train from her home in South Central to Norwalk.
"They doing something wrong and they playing with
his health.... My son is not no pet that you can
give different medications to see if they work."
The people overseeing Johnny's care, however, insist
there is a rigorous process for ensuring that
children at Metropolitan are medicated properly.
"We have well-trained psychiatrists and a review
committee that reviews medications given children,"
says John Hatakeyama. "It includes the hospital
pharmacist, the medical director of the hospital,
physicians in the hospital setting. We also have our
own medical director in the Department of Mental
Health, and he's routinely reviewing those
medications over and above the hospital."
Under a 1999 law passed in response to news reports
of children being overmedicated in Southern
California foster homes, juvenile court judges also
review drug regimens. The law, sponsored by Terry
Friedman, a former state assemblyman who is now
presiding judge of the L.A. County juvenile court,
requires judges to ensure that proper protocol is
followed before a child is put on psychotropic drugs.
That protocol, according to Randee Motzkin,
supervising research attorney for the juvenile
court, includes making sure the child receives a
specific psychiatric diagnosis, adjunct treatment
such as therapy, and any necessary lab work required
when taking certain drugs. L.A. County's juvenile
court also has a mental-health unit that reviews
children's diagnoses and can recommend that a judge
approve or reject certain medications. As required
by the new law, Johnny's medications have been
authorized by a judicial officer, and the
mental-health unit has deemed them appropriate.
Despite all the supposed safeguards, independent
psychiatric experts consulted by New Times say
Johnny's treatment is endangering his health and
future. Each day he spends shuttered away like a
prisoner, his system overloaded with antipsychotic
medications, the damage to the fifth grader grows,
they say.
Locked psychiatric wards "are not good places for
kids of any stripe. One ought to be really thinking
about what else should be done for Johnny," says Dr.
Loren Mosher, a psychiatrist who ran San Diego
County's Mental Health Services department until
1998, and who is now a professor of psychiatry at
the UC San Diego medical school. Mosher, who
reviewed some of Johnny's records at New Times'
request, describes the boy's care as a miserable
failure.
"It's pretty clear he really hasn't responded to any
of these drugs. You have a very messed up experiment
because you don't know what's going on with any of
these drugs," says Mosher. "The psychiatric ward
at Met State Hospital has a very bad reputation....
It's a prison where kids are locked up.... One ought
to really be thinking about what else should be done
for Johnny."
Mosher, a nationally known expert in treating mental
illness in nonhospital settings, says Johnny needs to
be weaned off the psychiatric medications and treated
in a less restrictive, noninstitutional environment.
If that does not happen, he will be transferred to
the adult unit of Metropolitan State Hospital, where
he is likely to spend the rest of his life. "Johnny
is in trouble," warns Mosher.
Breggin, the Maryland psychiatrist and author, is
equally worried about the boy. He says that if
Johnny is not rescued from his current life of
institutionalization and psychiatric medication, the
prognosis is grim. "They've already permanently brain
damaged him, and they are going to destroy him," he
says. "Every day is a new threat to him. He's going
to deteriorate from these drugs."
Johnny, of course, knows nothing about the
controversy over using psychotropic drugs on kids
like him. He doesn't even seem to understand his
past or future. Although he was sent to Metropolitan
in August, he thinks he's lived there only a few
days. As a reporter watches, his mother shows him
pictures of his brother and sister. "That my
house?" he asks. Then he inquires about his father. "Where my
daddy at?" he asks. His mother says bluntly, "He
robbed a bank." "Why?" prods Johnny. "I
don't know," she responds.
The boy is not sure why he is in the hospital. "My
behavior," he says, as if by rote. "Not
listening." Then, breathing heavily as if fighting sleep, he
says, "When I was playing football, there were
babies walking."
Sitting at a table in a hospital conference room,
Johnny stares ahead blankly, his head drooping. He
is asked what he wants to do when he grows up. "Get
a life," he replies quietly. Pressed to explain, he
waits several seconds, then says, "I don't know."
In the background, children are screaming and a
young, pale boy with greasy hair is being strapped
down on a restraining bed.
{ http://www.newtimesla.com/issues/2000-11-16/feature.html/page1.html
}
For more information on psychiatric rights,
see http://www.MindFreedom.org
and
http://www.breggin.com
DENDRITE is a public Internet alert system about human rights in psychiatry, sponsored by Support Coalition
International, sending out notices to thousands of concerned people, many of whom take ACTION NOW!
Support Coalition International is an independent non-profit federation of more than 70 groups in 11 countries united
to WIN campaigns for human rights in the "mental health system." For info on Support Coalition, see the web site:
www.efn.org/~dendron
