!!

!!!!

Chapter 24 !!!!!!!!!!!!

THE CULTIVATION OF BEAUTY

ON BEING MENTALLY ILL – What Hope?

POSTED ON JANUARY 26, 2014 BY MARISSA K. VARCHO

(http://thecultivationofbeauty.files.wordpress.com/2014/01/fdf7d-vintageflower5.jpg)

REFLECTION FROM JANUARY 26 , 2009 @ AGE 27

RE: WHETHER BEING BIPOLAR MAKES ME LESS THAN A HUMAN BEING.

I don’t know, I spoke with Maureen from IOP (“intensive-outpatient” group therapy)yesterday and I started crying because I realized that I didn’t feel like I was someoneworth loving. Maureen said that I was, and that everyone is fucked up in some way or

TH

another and that it’s really nobody’s business that I’m bipolar, that I don’t have to tellanyone if I don’t want to. People just marvel at me, that I’m so smart and witty and fun andbeautiful–they just can’t believe I wasn’t snatched up some long time ago. But I wasn’t,probably due to my undying particularity. I just want to know…will it keep me aloneforever? Or is love right around the corner? I want to know. I’m tired of waiting…I justwant to know already. It’s so difficult to be patient when everyone else around me hasfound love with simple ease. I can’t understand why it’s so difficult for me, why life is justso damn difficult for me. Do I make it difficult, or have I just fallen upon difficultcircumstances? Was life meant to be difficult for me? Or am I just fucking everything upin trying to be “me”? Maybe I’m not really supposed to be “me”. No, that can’t be…

POSTED IN KYRIELLE ADELSHINE, MISERY & SUICIDE | TAGGED BEAUTY, BELIEF,BIPOLAR, DARKNESS, HONESTY, HUMAN CONDITION, LOVE, MENTAL ILLNESS,PAIN, REFLECTION, STRUGGLES, TIME |

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4/13/14, 11:36 PMRights of mentally ill key in legislative debate | The Columbus Dispatch

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Empowering Ohio judges to order people with serious mental illness to get out-patient treatment — whetherthey want it or not — is stirring debate between advocates who say it will save lives and opponents who fear thatrights will get trampled.

For example, Amanda Baker, 24, of Dayton, wants her mother to be able to ask a court to order her to getoutpatient treatment if she has another mental breakdown. “If I ever find myself in that situation again, I wantmy loved ones to be able to get me treatment, whether I think I need it or not,” she said.

But Marissa Varcho, 32, of Powell, who has bipolar disorder, believes differently. She says forcing her to receivetreatment against her will would be “an abuse of power over our mentally ill population.”

House Bill 104 has passed the lower chamber. A companion measure, Senate Bill 43, is expected to be voted onthis week by the Senate Civil Justice Committee, setting the stage for a final legislative vote.

The legislation is supported by the National Alliance on Mental Illness Ohio, but it is opposed by the OhioCouncil of Behavioral Health & Family Services Providers. Hubert Wirtz, the council’s chief executive officer,told the Senate committee last week that the legislation is a “feel-good bill” that would provide no additionalfunding.

“Without an investment in services, this legislation perpetuates the illusion of treatment and fuels false hope forfamilies,” Wirtz testified.

NAMI Ohio Executive Director Terry Russell counters that the bill is “a matter of life and death. Not taking anyaction is unacceptable. ... There’s two sides to this, and you have to weigh both sides. ... NAMI Ohio is extremelyconcerned if anyone’s rights are violated, and we will closely monitor that.”

Judges in Ohio can sentence people to confinement in state psychiatric hospitals.

However, Pickaway County Probate Court Judge Jan Long said there is a difference of opinion among judgesabout whether state law authorizes them to require people to get involuntary outpatient treatment. Long toldthe Senate committee last week that a handful of judges are sentencing people to outpatient treatment, but mostare not, so clarification is needed.

The family of Richard C. Roderick says the former lawyer and Gallia County Common Pleas Court judge couldhave received help had the law been in place last year.

Roderick, 71, who was a judge from 1981 to 1986, developed mental illness after leaving the bench. His lawlicense was suspended by the Ohio Supreme Court for erratic behavior.

Roderick received mental-health treatment and took medications sporadically, but he suffered a majorbreakdown last fall. He was arrested after allegedly tying up and sexually assaulting his wife in their home onNov. 23.

By Alan Johnson

The Columbus Dispatch • Monday January 27, 2014 8:38 AM

Comments: 3 1 6 73

4/13/14, 11:36 PMRights of mentally ill key in legislative debate | The Columbus Dispatch

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Chris Roderick of Columbus, Richard’s brother, and Millie Tootle of San Antonio, his sister, said in separateinterviews that they wanted desperately to get treatment for their brother but could not legally do so.

“If I could have kidnapped him and gotten him into treatment, I would have,” Chris

Roderick said. “The law would be a good idea. Without that, they just shuffle guys like Dick off into a black hole.I can’t figure out what’s been done to him. I can’t know what meds he’s been given.”

State Rep. Margaret Ann Ruhl, R-Mount Vernon, sponsor of House Bill 104 along with Rep. Peter Stautberg, aRepublican from a suburb of Cincinnati, said getting mental-health treatment is critical for people who mightpose a threat to themselves, family members or others but have a history of refusing treatment.

Disability Rights Ohio, a nonprofit that advocates for people with disabilities, opposes the bill because it doesnot provide due-process protection for people whose rights could be violated. The agency recently gatheredopponents who have experience with mental illness to discuss their concerns with The Dispatch.

“The law is going to have some really bad consequences,” said Jack Cameron, 60, of Canton, representing theOhio Empowerment Coalition, a group that advocates peer support as the primary means of mental-healthtreatment. “Everything is about forcing people into treatment. I think forced outpatient treatment is going toscare people away.”

Pat Risser, 61, of Ashland, who struggled for years with mental illness, said he opposes forcing people to gettreatment and take medications that might have harmful side effects. “You’re playing a guessing game withpeople’s lives and civil liberties.”

Marissa Varcho, who is a lawyer, said her mental-health issues began when she was in high school andworsened over time. “As an adult citizen of this state and this country, nobody should take from me the right todecide which, and how much and when, I will take any given medication, if any at all,” she said in testimony.“We are speaking of my body, and it is my right to make these decision myself.”

By contrast, Baker said she supports mandatory treatment, as does her brother, Ben, 20, who also suffers frommental illness. He was hospitalized after crashing into a police car during a breakdown.

“It’s necessary and can help a lot of people with mental-health diagnoses get help,” Baker said. “Most peoplethat have episodes don’t do wonderful things. ... Your family can’t just bring you in there without any proof. Irealize that, in the moment, I may be angry because I’m in a episode, but later I will be grateful.”

In Summit County, judges have successfully used court-ordered outpatient treatment since the early 1990s, saidDr. Mark Munetz, chairman of psychiatry at Northeast Ohio Medical University and former chief clinical officerfor the Alcohol, Drug Addiction & Mental Health Services Board in Summit County.

“It has been successful for a substantial number of those individuals,” he said. “It’s not a ‘one size fits.’”

Munetz estimated that as many as 90 Summit County residents are on court-ordered treatment at a time, allwithout extra state or local funding.

“It was always our position that the people who meet the conditions are among the sickest people and should bea priority.”

People who skip out on court-ordered outpatient treatment can be picked up and taken back to court for re-evaluation, he said.

“We’re very cognizant of patient rights,” Munetz said. “It’s balancing what’s in the best interest of the patientswith community safety.”

ajohnson@dispatch.com

@ohioaj

4/13/14, 11:36 PMRights of mentally ill key in legislative debate | The Columbus Dispatch

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THOMAS REES (TOM-R2)

From the article: Marissa Varcho, who is a lawyer, said her mental-health issues began when she was in highschool and worsened over time. "As an adult citizen of this state and this country, nobody should take from me the rightto decide which, and how much and when, I will take any given medication, if any at all," she said in testimony. "We arespeaking of my body, and it is my right to make these decision myself." I fully understand why everyone wants to havethe right to say what goes on in their life. However, if someone is having a psychological episode where they are notcapable of making rational decisions and still wants to say what they want and don't want, then they have to accept theresponsibility of their actions while in that episode. You can't have it both ways. If you want that decision making right,then don't claim "innocent by reason of insanity" after a criminal act has been done. I realize this won't be a problem forthe majority of people who have a mental illness condition, but for those who become violent, you can't have it bothways.

2014-01-27 10:02:42.0

READER READER (READER)

These are really tough issues. I believe that the Disability Rights Association hit the nail on the head bypointing to due process. No one should lose their rights to self-determination without a court procedure in which theirrights are protected by counsel. However, to leave the door wide open ignores the reality that those whose rationality isimpacted by their illness cannot be relied upon unaided to make decisions in their own best interest, let alone those ofsociety. But we must also be fully cognizant that access to mental health treatment, particularly for those on the lowestsocietal rungs, is sadly lacking in this country. Medication alone is seldom an adequate treatment. Those who advocatefor peer-assisted support are aware of a critical (and nearly completely overlooked) component. In addition, behavioraltreatment is frequently needed in order to assist those with mental illness in understanding the impact of their illnesson others and how best to respond.

2014-01-27 10:56:28.0

SHELLY PETERSON (SHELLYPETERSON)

Involuntary treatment isn't for people who are able to walk into a psychiatrist's office and ask for help. It's forthose that aren't able to due primarily to severe psychosis and a lack of insight into their illness. The public systemshould be reserved for these people. Rather, we are spending billions of tax dollars on a system that caters to people thataren't that sick and those people advocate against the sickest people getting the care they need. They end up homeless,which isn't free to taxpayers. Billions are spent on homeless outreach programs with rescuing mentally ill homelesspeople always used an excuse for the funding. Most people that aren't allowed into the behavioral health care systembecause they are too sick to get there on their own almost always end up incarcerated, which last time I checked, wasn'ta voluntary procedure. We either need to get the professional patients who get paid to advocate against the sickestpatients out of the system entirely, or they need to step up to the plate and take care of these people themselves, whichthey currently do not do.

2014-01-27 15:22:06.0

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8

THE STATE OF OHIO’S “AOT” LAW COMPROMISE ~

Proposed By: MARISSA K. VARCHO

~ Presented In:

—COMPROMISE BETWEEN— S.B.43/Sub.H.B.104 Proponents & Opponents:

—IN SUPPORT OF THE BEST-INTERESTS OF OHIO’S MENTALLY-ILL POPULATION— ~

Submitted: JANUARY 27th, 2014

—to—

THE OHIO SENATE CIVIL JUSTICE COMMITTEE ~ !

“I don’t want to scare you,” he said, “but I can very clearly see you dying nobly, one way or another, for some highly unworthy cause.” … “Here’s what he said: ‘The mark of the immature man is that he wants to die nobly for a cause, while the mark of the mature man is that he wants to live humbly for one.’” … “I think that one of these days,” he said, “you’re going to have to find out where you want to go. And then you’ve got to start going there. But immediately. You can’t afford to lose a minute. Not you.” … “And I hate to tell you,” he said, “but I think that once you have a fair idea where you want to go, your first move will be to apply yourself in school. You’ll have to. You’re a student—whether the idea appeals to you or not. You’re in love with knowledge. And I think you’ll find, once you get past all the Mr. Vineses and their Oral Comp—” !

~ !“Once you get past all the Mr. Vinsons, you’re going to start getting closer and closer—that is, if you want to, and if you look for it and wait for it—to the kind of information that will be very, very dear to your heart. Among other things, you’ll find that you’re not the first person who was ever confused and frightened and even sickened by human behavior. You’re by no means alone on that score, you’ll be excited and stimulated to know. Many, many men have been just as troubled morally and spiritually as you are right now. Happily, some of them kept records of their troubles. You’ll learn from them—if you want to. Just as someday, if you have something to offer, someone will learn something from you. It’s a beautiful reciprocal arrangement. And it isn’t education. It’s history. It’s poetry.” !

~ !“I’m not trying to tell you,” he said, “that only educated and scholarly men are able to contribute something valuable to the world. It’s not so. But I do say that educated and scholarly men, if they’re brilliant and creative to begin with—which, unfortunately, is rarely the case—tend to leave infinitely more valuable records behind them than men do who are merely brilliant and creative. They tend to express themselves more clearly, and they usually have a passion for following their thoughts through to the end. And—most important—nine times out of ten they have more humility than the unscholarly thinker. Do you follow me at all?” !

—THE CATCHER IN THE RYE— J.D. Salinger

TABLE OF CONTENTS !!INTRODUCTION: EXTINGUISHING THE STIGMA — Sociological Responsibility..…………..….3 !

I. ACT 1 — ADMITTING FEAR…………………………………………………………………………………..4 !II. ACT 2 — RECOGNIZING PAIN………………………………………………………………………………4 !III. ACT 3 — VALIDATING SUFFERING………………………………………………………………………4 !IV. ACT 4 — RECOGNIZING SHAME…………………………………………………………………………..5 !V. ACT 5 — ADMITTING BLAME……………………………………………………………………………….8 !

CLOSING: EXTINGUISHING THE STIGMA — Reframing The Mental-Health Issue………….…12 !! !!

Page ! of !2 14

INTRODUCTION !—EXTINGUISHING THE STIGMA—

RECOGNIZING SOCIETY’S CURRENT CONTRIBUTION ! I trust, by this point, that you each have taken the opportunity to view “The New Face of Mental Illness” video/DVD to which I personally served each of your office-personnel on January 21st, 2014—most notably, of course, in light of the exceptional speed with which you have intended to handle Ohio’s proposed AOT-legislation to-date. In case you have not—I now cause to be known my most sincere hope, that you will soon make the time, so as to educate yourself with regard to the overwhelming sociological stigma and systemic discrimination presently being perpetrated against our mentally-ill population by our society at-large, in addition to the myriad of conflicting interests and overall incompetencies which so generally plague our state’s mental-health medical support network presently. For purposes of facilitating change—I will presume said comprehension, and jump immediately to the point. ! I propose the following AOT-law compromise to serve the best-interests of Ohio’s mentally-ill population: !AOT-OPPONENTS CONCEDE—initiating, in the name of our AOT-compromise: !

(1) To widen the legal standard as per Sub.H.B.104 section 5122.01 (B), under which a “mentally-ill” individual may be forcibly subjected to AOT (“assisted” outpatient “treatment”); and

(2) To take such action despite the absence of an appropriation or any other source of funding and corresponding implementation-plan, through which to resolve our mental-health medical care “support” system’s general incompetencies; whereas— !

AOT-PROPONENTS CONCEDE—responding, in the name of our AOT-compromise: !(3) To heighten short-term mental-health consumer-protection by enhancing

legal safeguards in our AOT-legislation, for all mentally-ill individuals involuntarily compelled into the AOT-system; and

(4) To heighten long-term mental-health consumer-protection by adding legal incentives into our AOT-legislation, to combat sociological stigma, suppress societal discrimination, and at least begin to raise the competency of our mental-health medical care support system. !

To accomplish these objectives, I propose the following-outlined revisions for Sub.H.B.104 to create a working outline for our pending mental-health AOT-legislation compromise. !!!!

Page ! of !3 14

I. ADMITTING FEAR — Learning to Lead. ! First, I propose that we extinguish the unsubstantiated and discriminatory link created legally between the mentally-ill and gun-violence by removing R.C. 2923.12 (D)(1)(i) @ page 35, amending R.C. 2923.1213 (2)(B)(i)(b) @ page 44 accordingly, and then removing R.C. 2923.13 (A)(5) @ page 50 as well. !!II.RECOGNIZING PAIN — Leading Fearlessly. ! Next, I propose that we provide for each person going through a mental-health crisis so severe that forced-AOT would even become necessary, the requisite “support-team” that is needed, by adding “ACT team” language paralleled from New York’s Kendra’s Law (as we did with our new definition of “mentally-ill person” under Sub.H.B.104 at section 5122.01), into the definition of “treatment plan” under R.C. 5122.01 (V)(1) @ page 105, which shall: !

‣ Specifically include language requiring a “team-leader” — to be fulfilled necessarily — and by the start of the second year of Ohio’s implementation of its AOT compromise, to be filled necessarily by a licensed social worker; !

‣ Thereby guaranteeing for every “mentally-ill” person subjected to AOT: Help coordinating communication and service supports as between attorney,

psychiatrist, psychologist, insurance company, pharmacy, work, family, etc.; and

Assistance in setting up a long-term treatment plan (i.e. locate housing, obtain vocational skills, find employment to reinforce self-worth and create means from which ongoing psychiatric treatment—psychiatrist, psychologist and medications—can be paid, etc.). !!

III.VALIDATING SUFFERING — Leading Ethically. ! To ensure the dignity and self-autonomy of our mentally-ill population, I propose that we provide for all necessary channels that constitute the basic support foundation requisite to enable a full-functioning, long-term treatment plan for each individual subjected to AOT by removing the Sub.H.B.104 revision to R.C. 5122.01 (V)(2) @ page 105 so as to keep “housing, financial, and vocational services” language in the law; while maintaining the remainder of services detailed by proposed addition in Sub.H.B. 5122.01 (V)(2)(a) through (i). ! I propose that we create an incentive to increase the competency of Ohio’s police force in handling mental-illness-related emergency situations, by permitting only parole officers, police officers and sheriffs who have had “CIT training” to act pursuant to the terms of R.C. 5122.10 @ page 109, R.C. 5122.11 @ page 112, line 3466 and R.C. 5122.141 (D) @ page 119. !

Page ! of !4 14

Similarly, I propose that we create an incentive to increase the accountability of any person filing an “affidavit” to initiate AOT-proceedings, by revising R.C. 5122.11 @ page 112 as follows: !

‣ Making the presently-optional accompaniment of a “certificate” mandatory, such that every AOT-affidavit SHALL necessarily be accompanied by either: ! A certificate stating that the person…(remainder of language to remain the

same) as prepared by either: • A board-licensed psychiatrist; or • A board-licensed clinical psychologist and a board-licensed

physician; or A written statement by the applicant made under oath, stating that the

person for whom AOT is sought has refused to submit to an examination by a psychiatrist of the person’s choice (i.e. the Respondent’s choice, not the applicant’s choice), or by a licensed clinical psychologist and licensed physician of the person’s choice (i.e. at the Respondent’s choice); and !

‣ Adding language to this same section stating that any affidavit filed in the Probate Court or elsewhere to initiate AOT proceedings shall be immediately dismissed upon the Court’s receipt of notice that respondent did, in fact, submit to examination as per the preceding R.C. 5122.11 language, and that it was determined by the requisite mental-health/medical professional(s) that the respondent not be subjected to AOT. !!

IV.RECOGNIZING SHAME — Leading Humbly. ! Continuing forward, I propose that we increase the accountability of mental-health medical-providers and promote continuity of mental-health medical care for all individuals subjected to AOT by requiring all of the following substantive content to be included in the “certificate” under R.C. 5122.11 @ page 112: !

‣ All factors weighed in consideration, which led to the conclusion that the respondent is “mentally ill” as required under Sub.H.B.104’s proposed 5122.01 (B); !

‣ Specific recommendations as to particularly applicable short-term and long-term psychological treatment techniques (i.e. treatment options other than medication) that are substantially likely to help improve said individual’s present and future life-circumstances, detailing all of the following: !

To which particular circumstances of the individual’s present situation the recommended techniques specifically apply and relate;

Page ! of !5 14

Why the recommended techniques support the best-interests of the individual presently (i.e. why it is thought that the recommended treatment will be effective by the three (3) month end of the forced-AOT period); and

Why the recommended techniques will inure to the individual’s future benefit, particularly addressing all prior treatment attempts by the individual which returned little or no significant benefit; and !

‣ Verification that the psychological treatment techniques recommended will be substantially likely to prevent the individual from inflicting grave and imminent risk of harm to self and others. !

For all cases wherein a “temporary order of detention” under R.C. 5122.11 @ page 112 is issued, I propose that we shift the onus for the timing of the filing of the “report” under R.C. 5122.13 @ page 118, line 3613 off of the mental-health consumer who is in the midst of a mental-health crisis and experiencing the trauma of forced-AOT, and back onto the government by: !

‣ Requiring, where a person is transported to a hospital or other designated place under the temporary order, that the “report” by the local ADAMH/etc. board (determining availability of appropriate treatment alternatives) be completed and submitted to the Probate Court within three (3) calendar days from the beginning of the time of custody; noting—said time would include “weekend” days such that, if custody begins on Thursday, then the “report” must be submitted before court closing on Friday; and !

‣ Adding language to R.C. 5122.13 @ page 118, line 3626 noting that if a temporary order is issued pursuant to R.C. 5122.11, then R.C. 5122.11 must be followed for timing requirements as it relates to the filing of the “report” referred to in R.C. 5122.13 @ line 3613. !

In addition, I propose that we manage ADAMH, etc. “board” discretion as per the R.C. 5122.13 @ page 118, line 3613 treatment “available” determination for purposes of preparing their “report” to be filed with Probate Court, by revising lines 3606 through 3611 as follows: !

‣ If the “affidavit” is filed under R.C. 5122.11 with a “certificate” (as per the above-outlined revisions), then “the board or services provider shall review” the certificate only (i.e. not the Affidavit);

‣ If the “affidavit” is filed under R.C. 5122.11 without a “certificate” (i.e. Respondent refused to submit to examination by mental-health/medical professional(s) of his/her own choice), then “the board or services provider shall review the allegations of the affidavit” and determine the availability of appropriate treatment to the best of their ability;

‣ MEANING—if the Respondent chose to submit to examination by mental-health/medical professional(s) of choice, and pursuant to same, was determined to be subject to AOT—then the recommendations outlined in the “certificate” must be

Page ! of !6 14

followed by the “board”; but if the Respondent refused to submit to examination, only then can the board use its discretion to determine what treatment is “appropriate” as per current law and as noted in Sub.H.B.104 @ page 118, line 3610. !

I propose that we sociologically accept responsibility for providing legal assistance under R.C. 5122.15 (A)(3) @ page 120 to persons in such severe mental-health crises so as to become subject to AOT, by: !

‣ Providing court-appointed counsel to all Respondents in all AOT cases, at least initially, and ongoing until it has been determined that a Respondent is in fact not indigent, or has otherwise waived such right to counsel—with all costs incurred legally up until that point, to be funded by taxpayers; !

‣ NOTING—the Respondent, who is in the middle of a mental-health crisis, and in many cases has already been detained, will need time and help arranging for counsel and should not be penalized in the meantime for lacking such capability; and !

‣ NOTING—this provision will help alleviate some of the concern that AOT-petitioners will use the AOT procedure to mentally/emotionally abuse/bully a respondent (i.e. less-than well-intentioned family members), as the Probate Court will have little tolerance for frivolous affidavits/repeat filers/AOT-procedure-abusers, etc. !

Similarly, I propose that we raise sociological responsibility for protecting our weaker humanity by addressing the right to an “independent expert evaluation” under R.C. 5122.15 (A)(4) @ page 121 with the following revisions: !

‣ In all cases where an “affidavit” was filed in the absence of an accompanying mental-health medical professional “certificate” (as per the above-outlined R.C. 5122.11 revisions)—then an “independent expert evaluation” shall be conducted (unless waived by Respondent), by means of an “expert” chosen at the Respondent’s discretion (unless choice waived by Respondent), and shall be funded by taxpayers; and

‣ Said “independent expert evaluation” shall include the same substantive content as required in the “certificate” as indicated in the above-outlined R.C. 5122.11 revisions;

‣ NOTING—this is an additional protection for individuals who have been subjected to AOT for the reason that they are in the midst of serious mental-health crises—therefore being in an extremely vulnerable mental and emotional state—providing them the benefit of the doubt and thereby working to combat our sociologically-programmed stigma against them; and

‣ OTHERWISE—removing all remaining language in this section relating to “counsel” (see above-outlined R.C. 5122.15 (A)(3) revisions). !

In addition, I propose that we enhance mental-health consumer protection by clarifying legislative intent in R.C. 5122.15 (A)(6) @ page 121 by providing the definition for “legitimate interest” as used @ line 3710 regarding admission of persons to otherwise closed AOT-hearings.

Page ! of !7 14

! In order that we can strengthen continuity of mental-health consumer medical care, decrease potential for AOT-law petitioner-abuse, and increase accountability of AOT court-procedure and court-personnel, I propose that we also enhance AOT procedural-transparency by revising R.C. 5122 (A)(14) @ page 122 as follows: !

‣ The Court shall make and maintain a full transcript and record of the proceeding (i.e. it is mandatory in all cases—to be kept on court file indefinitely, and removed only upon either Respondent’s request or Respondent’s death); and !

‣ If the Respondent is not represented by counsel, a copy shall be provided to the Respondent (i.e. in all pro-se cases); !

‣ NOTING—this removes the requirement that a copy of the transcript/record be provided to a pro-se Respondent only upon his/her “request”—for the reason that the mental-health consumer/Respondent, who may or may not be in the middle of a mental-health crisis will, in any case, likely have no idea said right even exists. !

Moreover, to increase mental-health consumer protection by reducing the potential for court-personnel abuse-of-discretion, I propose that we revise R.C. 5122.15 (E) @ page 123 so as to limit the court’s consideration, in determining an AOT-patient’s “treatment plan”, to the following three factors (alone—i.e. exclusively-speaking): !

‣ Preferences of the Respondent; ‣ Least restrictive alternative available; and ‣ Either:

The “certificate” recommendations as per the above-outlined R.C. 5122.11 revisions; or

Both of the following: • The county board “report” recommendations as per the above-

outlined R.C. 5122.13 revisions; and • The “independent expert evaluation” recommendations as per the

above-outlined R.C. 5122.15 (A)(4) revisions. !!V. ADMITTING BLAME — Leading Consciously. ! Lastly, and with greatest regard, I propose that we reinstate mental-health consumers’ constitutionally-guaranteed civil rights at the expiration of 90-days under court-ordered treatment by revising R.C. 5122.15 (H) @ page 125 with the following language: !

‣ “At the expiration of ninety-days from a “temporary detention” as per R.C. 5122.10 or 5122.11, an “interim detention” as per R.C. 5122.141 (D), or a court-order for

Page ! of !8 14

inpatient or outpatient treatment, whichever date is earliest—the Respondent/AOT-patient shall be released.”; !

‣ Deleting the remainder of R.C. 5122.15 (H) as well as the following sections (I), (J), (L) and (M); and !

‣ Revising R.C. 5122.15 (K) to read—“An order of the court under division (C) or (H) of this section is a final order”; !

‣ NOTING—there is no “ongoing” denial of a human being’s civil liberties and constitutional rights; the state government and its mental-health medical support network gets 90-days to help rehabilitate a person in mental-health crisis—that’s it; !

‣ NOTING—if the mental-health “crisis” is just ongoing indefinitely, then we need to figure some other long-term procedure with which to deal with that instance, separately from AOT; thereby acknowledging then, that any other solution that just lumps the whole group together is discriminatory; !

‣ NOTING—if the government/petitioner/etc. feels that Respondent should still be subjected to AOT after the 90-day expiration, then the government/petitioner/etc. can begin the AOT proceedings again (i.e. giving the Respondent a “fresh start” with a new opportunity to choose to “be free”); and, finally— !

‣ NOTING—this provision, in particular, will push us towards figuring out how to quickly raise the competency of our mental-health medical care support network and correspondingly, raise the overall compassion and humanity with which we “treat” our mentally-ill population. !

And then logistically speaking, I propose that we correspondingly revise the remainder of Sub.H.B.104 in the following manner: !

‣ Revise the last sentence of R.C. 5122.19 @ page 128, contained within lines 3934 through 3940, to read—“Such an examination shall be held within twenty-four (24) hours after the time of arrival, and if the chief clinical officer fails within such a time to certify that in the chief clinical officer’s opinion the person is a mentally ill person subject to court order, the person shall be immediately released.” !

‣ Revise R.C. 5122.21 (A) @ page 128, lines 3941 through 3945 to read—“The chief clinical officer shall examine every Respondent/AOT-patient at least once every seven (7) days, recording for each examination the Respondent/AOT-patient’s current status, differential diagnosis, probable prognosis, and description of the current treatment plan on the Respondent/AOT-patient’s official chart, and, whenever the chief clinical officer determines that the conditions justifying involuntary hospitalization or court-ordered outpatient treatment no longer apply, shall…(remainder of section to stay the same).

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!‣ Revise R.C. 5122.27 (A) @ page 129 to read—“Receive, within two (2) days of their

admission, professional medical care of sufficient competency to accurately evaluate every Respondent/AOT-patient’s current status, differential diagnosis and probable prognosis, and to assure that all of the afore-mentioned information along with a description of the current treatment plan is stated in the Respondent/AOT-patient’s official chart;”. !

‣ Revise R.C. 5122.27 (B) @ page 130 to read—“Have a written treatment plan consistent with the evaluation, diagnosis, prognosis, and goals which shall be provided to the patient and patient’s counsel;”. !

‣ Revise R.C. 5122.27 (D) @ page 130 to read—“Receive periodic reevaluations of the treatment plan by the professional staff at intervals not to exceed seven (7) days, except where treatment includes medication, which shall require more frequent periodic reevaluations of the treatment plan by the professional staff at intervals not to exceed three (3) days, with status updates noted in the Respondent/AOT-patient’s official chart for every reevaluation;”. !

‣ Revise R.C. 5122.27 (E) @ page 130 to read—“Be provided with competent medical treatment for all physical and mental disease and injury as required by the state medical and psychological board associations;”. !

‣ Clarify legislative intent under R.C. 5122.27 (F) @ page 130 by including its specific definition of “humane”. !

‣ Clarify legislative intent under R.C. 5122.27 (E)(3) @ page 130 by including the definition of “a humane psychological and physical environment”—specifically noting that forcibly administering medication falls outside the definition of “humane”. !

‣ Revise R.C. 5122.27 (E)(4) @ page 130 to read—“The right to be provided any and all information concerning the Respondent/AOT-patient’s treatment program and expectations in honest, straightforward terms that the Respondent/AOT-patient is capable to reasonably understand;”. !

‣ Revise R.C. 5122.27 (E)(6) @ page 131 to read—“The right to be free from unwanted medication;”. !

‣ Revise R.C. 5122.27 (E)(7) @ page 131 to read—“Freedom from restraints and isolation.” !

‣ Revise R.C. 5122.27 (E) @ page 131 as follows: Revise lines 4012 through 4014 to read—“provide the treatment required by

divisions (A) through (F) of this section for any patient hospitalized or

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committed to outpatient treatment pursuant to Chapter 5122. of the Revised Code, the chief clinical officer shall”; and

Revise line 4018 to read—“If within two (2) days after issuance of the aforementioned immediate notification by the”. !

‣ Revise R.C. 5122.30 @ page 131 by deleting lines 4034 through 4039, NOTING—burden is on government/AOT-petitioner, not on Respondent/AOT-patient for whom we are now providing the benefit-of-the-doubt. !

‣ Revise R.C. 5122.31 (A)(1) @ page 132 by deleting lines 4048 through 4052 NOTING—this constitutes an unnecessary, repetitive recital of an individual’s, legal guardian’s and/or parent’s legal rights. !

‣ Revise R.C. 5122.31 (A)(4) @ page 132 by deleting line 4063 NOTING—to provide no judicial discretion to alter an individual’s civil right to privacy. !

‣ Revise R.C. 5122.31 (A)(5) @ page 132 to read—“That Respondent/AOT-patient shall be granted access to Respondent/AOT-patient’s own psychiatric and medical records in part or in full, upon request, at any time;”—NOTING the clearly mentally and emotionally-abusive nature of the deleted portion of this section. !

‣ Revise R.C. 5122.31 (A)(6) @ page 133 by deleting lines 4068 through 4079, NOTING—all records that may be needed for such purposes in this section shall be maintained through the Probate Court; no private exchange permitted. !

‣ Revise R.C. 5122.31 (A)(8) @ page 133 by deleting lines 4086 through 4094, NOTING—this constitutes an unnecessary, repetitive recital of an individual’s legal rights for the purpose of disregarding the individual’s legal rights; clearly discriminatory. !

‣ Revise R.C. 5122.31 (A)(9) @ pages 133 - 134, by deleting lines 4095 through 4103, NOTING—all records that may be needed such purposes in this section shall be maintained through the Probate Court; no private exchange permitted. !

‣ Revise R.C. 5122.31 (A)(13) @ pages 134 - 135, by deleting lines 4117 through 4137, NOTING—this constitutes an unnecessary, repetitive recital of an individual’s legal rights for the purpose of disregarding the individual’s legal rights; clearly discriminatory. !

‣ Revise R.C. 5122.31 (B) and (C) @ page 135 by deleting lines 4138 through 4147 NOTING—we shall maintain sociological responsibility for the negligent release of a Respondent/AOT-patient’s medical records. !

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‣ Revise R.C. 5122.311 @ pages 135 - 136 by deleting lines 4148 through 4173 in the entirety—NOTING: the clearly stigmatic and discriminatory nature of this provision. !

‣ Revise R.C. 5305.22 @ pages 137 - 138 by deleting lines 4217 through 4244—NOTING the discriminatory nature of this provision, in removing a Respondent/AOT-patient’s property rights for the sole reason of his/her “disability”. !

‣ Revision “Section 2.” and “Section 3.” @ page 139 in accordance with the above-outlined revisions. !!

!

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CLOSING !—EXTINGUISHING THE STIGMA—

REFRAMING OUR SOCIOLOGICAL ISSUE ! To be clear, this proposal is meant to be taken neither definitively, nor exclusively—much work is left to be done. I have crafted this compromise to: !

1) Shift Ohio’s leadership focus back onto the mental-health consumer; and 2) Support Ohio’s choice—in writing for later use in combatting sociological criticism

—to set an unprecedented mental-health leadership example in supporting the mental-health consumer voice. !

This compromise will allow the State of Ohio the time it needs to become ready, willing and able to fund necessary action to substantially raise the competency of our mental-health medical support system—while recognizing for the meantime—that to force incompetent medical treatment upon any human being is not only grossly unethical and seriously immoral, but most notably, inhumane. Henceforth, we compromise to enhance mental-health consumer-protection whilst we work to heighten sociological responsibility and eagerly await continued, compassionate, funding-backed state action. In doing so, we, Ohio’s mental-health advocacy leadership community, set a new example for our children—showing them with our action—what it means to lead with genuine, heart-felt vision.

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— IN DEDICATION TO — !AMERICA’S MENTALLY-ILL CHILDREN !!

“Anyway, I keep picturing all these little kids playing some game in this big field of rye and all. Thousands of little kids, and nobody’s around—nobody big, I mean—except me. And I’m standing on the edge of some crazy cliff. What I have to do, I have to catch everybody if they start to go over the cliff—I mean if they’re running and they don’t look where they’re going I have to come out from somewhere and catch them. That’s all I’d do all day. I’d just be the catcher in the rye and all. I know it’s crazy, but that’s the only thing I’d really like to be. I know it’s crazy.” !!

—THE CATCHER IN THE RYE— J.D. Salinger

Marissa Varcho <marissavarcho@gmail.com>

Thanks

Marissa Varcho <marissavarcho@gmail.com> Mon, Jan 27, 2014 at 11:00 AMTo: Alan Johnson <ajohnson@dispatch.com>Bcc: Marissa Varcho <marissavarcho@gmail.com>

Thanks Alan, especially for getting it on the front page. We'll see what happens with Senator Coley here in just afew...

Sincerely,Marissa

Marissa K. Varchomarissavarcho@gmail.comhttp://thecultivationofbeauty.comhttp://janesaysrise.com

Marissa Varcho <marissavarcho@gmail.com>

Thanks

Alan Johnson <ajohnson@dispatch.com> Mon, Jan 27, 2014 at 11:04 AMTo: Marissa Varcho <marissavarcho@gmail.com>

You’re welcome. I’m sorry I didn’t get more from your comments and testimony in the story, but as you sawthere was a lot of ground to cover.

Is the hearing today?

From: Marissa Varcho [mailto:marissavarcho@gmail.com] Sent: Monday, January 27, 2014 11:00 AMTo: Alan JohnsonSubject: Thanks

[Quoted text hidden]

Marissa Varcho <marissavarcho@gmail.com>

Feedback?

Marissa <marissavarcho@gmail.com> Mon, Jan 27, 2014 at 2:48 PMTo: Johnson Betsy <betsy@namiohio.org>

Hi Betsy,

I was wondering if you received my email from this morning yet with the attached AOT-­compromise proposal,and if you'd had a chance to review already-­-­whether you had any feedback. I'll be at the meeting onWednesday, and I'm going to prepare a shorter, more theory-­based version of the proposal idea that's a bit easierto digest than all the technical legal jargon. But I did want to see if you had any feedback beforehand, toconsider and potentially incorporate. Let me know whenever you get a chance!

Thanks,Marissa

Sent from my iPhone

Marissa Varcho <marissavarcho@gmail.com>

Thanks

Marissa <marissavarcho@gmail.com> Mon, Jan 27, 2014 at 2:57 PMTo: Alan Johnson <ajohnson@dispatch.com>

Hi!

Thank you, I appreciate that ;;0) Not to worry though, it was most assuredly a lot of ground to cover and I thinktoo, a great start!

I met with Senator Coley today one-­on-­one and he was extremely receptive to my compromise-­proposal ideas (Icc'd you the email with the attachment this morning). He hadn't actually read it yet hah...but the five or so pointswe were able to hit in half-­hour's time were very well taken post-­analysis/explanation. So who knows-­-­no hearingthis week anymore actually. There's an interested-­parties meeting instead on Wednesday, to which the Senatorinvited me to come today. So that's pretty exciting. I'm going to prepare a summary for the compromise-­proposal with the theoretical bullet points easily outlined so I can argue them well. I have no idea what to expectas I've never been to an IP meeting before, I just know Betsy Johnson from NAMI Ohio and Michael Kirkmanfrom DRO will be there. I guess I'll soon find out! Anyways, I told you I go on and on hah! I'll keep you posted...

Marissa

Sent from my iPhone[Quoted text hidden]

Monday January 27th, 2014 3:40pm !Hi ;0) !I’m about to meet with Ohio House Representative Stinziano. So I’m pretty excited about that. !Actually, I’m really excited, because I met with Senator Coley today and he was very receptive to my AOT-Compromise proposal ideas. Like, I argued my points and he questioned them and I analyzed and he understood. It was awesome! !So, I don’t know what the hell that even means—if at all, anything, even…but it’s still pretty exciting ;0) !Plus the article I did the joint interview on with Alan Johnson for The Dispatch was on the front page of the newspaper today…along with my name!!! So that too…was pretty f’ing exciting ;0) !It’s just been a fun day. And I can’t wait to fill my Focalin Rx tomorrow, so then it will be even more fun because I will actually have some energy! Ughh! 9am—so…8 + 9 = 17 more hours to go and that’s it!!! !So anyways, I surely do hope Mr. Stinziano shows, because I’ve been waiting here at Stauf’s for him since about 2:30pm!!! !And I’m very tired as it is—but, so very glad to have this AOT-Law Compromise proposal for Ohio finally complete! !I feel like I really proved myself today—like, legitimately…and it feels great!