I need to write about a place I had to go to in June that was a complete hellhole. It was located in Bemidji, Minnesota and I have never been anywhere quite as bad for a lengthy period of time. Sure I’ve been stuck in horrible placements for a few days or so, but I was put in a place for over a month that neglected my physical and mental needs. Neglect is a very serious thing when it comes to vulnerable adults. We are often subjected to it and shot down when we try to speak up about it. Nobody believes us when we talk about it because who’s word are they going to take at face value: the “normal” person, or the “crazy” person? It’s not hard to figure out.
It was a Friday at 4:00. There was no warning. The director at my program said she needed to talk to me and pulled me into one of the conference rooms. I knew it wasn’t going to be good but I didn’t think the news was going to be as bad as it was, either. I thought I had broken one of the rules and was about to be reprimanded for it. Instead, she handed me a piece of paper. It was a revocation of my provisional discharge. For those of you that are unfamiliar with the term, if you are on a commitment for mental health, the courts can send you back to the hospital at any time for any reason. This is known as “revoking your provisional discharge.” They hand you a piece of paper detailing the reasons why they believe you need to be in a hospital and then the police come and get you and take you against your will. It feels like you’re being kidnapped. As someone who once was kidnapped at one point in time, I can tell you that it is the exact same feeling because you are taken somewhere you do not want to go against your will. I live in fear every day that this will happen again because it is always without warning.
“Tomorrow morning they are going to come and get you and take you to Bemidji,” the director explained to me.
“But…but…..but…..WHY?” I stammered, confused.
“It says here that your weight has dropped too much and that your potassium levels are also starting to drop, and that they can’t get you into an eating disorder treatment center, so they have to send you to a CBHH.”
This is where the confusion REALLY started to settle in. Community Behavioral Health Hospitals are not really hospitals. They do not treat you for any medical issues while you are there. They have a doctor who comes in every once in awhile, sure, but someone with vitamin deficiencies and a severe eating disorder would be placed at high risk in a facility that was not attached to a hospital. Medical monitoring needs to be done while the patient is refeeding, and if it’s not done, the patient could die. Sending me to a CBHH was negligence on the part of the state, and I still look back and shiver when I think about how likely it was that I could have died there. I told them that if they were going to send me to a psych ward, then they needed to send me to one that was attached to a hospital so that they could monitor me medically. They chose not to listen to me. I am an excellent self-advocate, but being on commitment complicates things and I often do not get my needs met, no matter how hard I fight.
My original plan was to sleep naked so that when the cops showed up to get me, they wouldn’t be able to take me out of the facility without clothes on. That would be indecent exposure. This would at least buy me some time to get something done and possibly prevent them from taking me. However, this plan obviously didn’t work. One of my favorite staff, Jenny, came in the next morning and said, “Don’t you want to go out with a little dignity? What they are going to do is drape a blanket over you and take you out anyway.” I put clothes on and planned to contact my lawyer as soon as I got there to see if I could have a trial and be placed somewhere else. Going the legal route generally works for me. The judge is impartial and listens to both sides. I felt like I had a good chance of getting moved if I did things that way.
It was 4 hours away. I slept during the entire ride. When I got there, the staff was friendly and welcoming and gave no indication of the nightmares I would later face. They did, however, make statements such as, “We’ve never dealt with an eating disorder before so we really don’t know what to do with you.” I could have told them that. This was not my first rodeo. I’d been to a CBHH before and they did not know how to handle anything correctly. The doctor talked to me for five minutes and decided I was psychotic and forced me to take Haldol. I have never been psychotic or exhibited signs of psychosis and this was the first doctor I’d ever seen that tried to say I was. Even though he wrote down that he thought I was psychotic, he lied to me and said, “I don’t think you’re psychotic. I’m putting you on the Haldol because I think your thinking is stuck and I want to get it unstuck.” Antipsychotics are not good for me because they give me bad reactions. Since I’m not psychotic, they actually make me psychotic when I take them. I start having persistent thoughts about self harm and suicide, and they make it impossible for me to lose weight no matter how little I eat, which in turn makes my eating disorder flare up. When I am underweight, my eating disorder does not pester me nearly as much as it does when I am a normal weight.
Though the initial staff was kind to me, the environment seemed hostile. There were patients and staff that glared at me. The feeling was entirely mutual. They didn’t want me there and I didn’t want to be there either. It was explained to me that I was only going to be there until they could get me into eating disorder treatment, which made me feel better, but I soon found out that that was a lie also.
I will use pseudonyms for the patients, but not for the staff. The staff needs to be held accountable for their words and actions, and I will not censor them. The only power I have right now are my words, so I will use them and hopefully they will make a difference. I will not be silent about my experiences. Maybe if I speak up, then things will change and others will not have to suffer like I did. Bear with me because I had a lot of negative experiences at this place and I want to detail all of them. I want you to know that they are real and that I will never go back to a CBHH, no matter what the courts say. I will jump the fence and run away and be homeless until November 22, the date my commitment is up. Anything is better than the verbal abuse and medical neglect at the hands of a CBHH. I am NOT trying to play the victim or say “oh poor me” or ANY of that. I am detailing my experiences exactly as they happened so that you know that this is real and that things like this DO happen. The format I’m going to write this in is going to be a little different than the others because I am going to write it by each separate incident.
There was a patient there that all the staff seemed to favor, and it was unclear to me why. His name was “Donny” and all he did was attack the staff and try to put them in a chokehold so he could grab their badges and try to escape. Like me, he didn’t eat or drink much, but he was put on a pedestal for it. Whatever Donny wanted, Donny got. If he wanted to eat in his room away from everyone, he could do it. Every time he came out of his room, he was treated like a king and offered food or drink. The favoritism was upsetting to me because everyone’s insurance was paying the same amount for us to be there, so I believe everyone should be treated equally. One patient should not be offered food and drink at times when it’s not available while everybody else can’t get it. That’s not good patient care.
I was scolded and met with disdain when I didn’t eat or drink, while he was met with understanding and kindness. One of the staff, Merrill, would often print off cutesy little quotes for Donny that said things like, “A body cannot function without fuel.” Basically, they were treating him like an eating disorder patient when he didn’t even have one.
They would often give him highly overexaggerated praise when he ate two bites at the dinner table while I was left to struggle in silence and tears. The staff told me that I could either “eat or die.” I began to have screaming panic attacks when I couldn’t eat (which was often) and became convinced I was going to die.
Whenever I brought up the favoritism with the staff, they often crowded around me and laughed at me and said, “What’s the matter? You jealous? You want attention?” No, I believe in fairness and equality. THAT is what was the matter. I believe no one should be singled out for special treatment. My protests led me to almost get attacked by another patient.
I’m using the pseudonym Aimee because it’s one of my least favorite names. There is a girl I know named Aimee in real life who has been stalking me for more than 6 months. I’ve blocked her on every possible social media account, but still she manages to get around all that and send me nasty messages. I don’t know why she is so obsessed with me, but I’ve sworn to her that if she contacts me again I’ll be getting a restraining order.
This girl had it in for me the moment I walked through the door. She glared at me with such hate in her eyes that I had to look away. She seemed to have a very negative attitude in general and was always complaining about something. Things didn’t come to a head until the time when I was struggling with my meal and the tears started gushing down my face. Picking up on my weakness, she loudly proclaimed, “I’m gonna get away from this fucker crying,” and then walked into the next room. I followed her and yelled through the window, “DON’T EVER FUCKING TALK TO ME THAT WAY AGAIN,” and she tried to come out the door and attack me.
The staff, Joel, who was a nurse, immediately began to take her side and declared, “SHE is calm. YOU are not. Are you okay, Aimee? Do you need anything?” SHE was the one who tried to attack ME. I yelled at him to butt out if he was going to take sides, and that I would sue them for every penny they had if they allowed me to get attacked by another patient. Joel acted very funny around Aimee. I wouldn’t have been surprised if he had a crush on her. He exhibited very strange, inappropriate behavior around her and was always singling her out for special treatment and taking her side when she acted hostile and violent towards other patients.
This was not the only incident with her. The next day, me and another patient were walking down the halls at 4:00 pm and talking. She came barreling out of her room and screaming at us to shut up because she was trying to sleep. Well, the world doesn’t revolve around you, honey. It’s not nighttime and we have every right to have a conversation in the hallway in the daytime. I told her this and she started screaming at me, “SKINNY BITCH! ANOREXIC BITCH!” Four staff had to restrain her from attacking me. “TOUCH ME AND I’LL KILL YOU!” I yelled back.
“YOU JUST MADE A TERRORISTIC THREAT!” One of the staff yelled at me.
“THEN PROSECUTE ME!” I yelled back. Of course they didn’t. They liked to try to intimidate me but it usually didn’t work. She left me alone after that. The staff continuously tried to scold me for that incident even though I was just defending myself. I stuck to my guns.
The worst staff at the place was named Brenda. She was always discriminating against me because of my eating disorder and would tell lies about me to the doctors. The weirdest thing she would do was come into my room in the morning and ask me, “Did you have any dreams about food last night?”
“Yes,” I’d answer.
“Well, that’s because you’re starving your body,” she’d say. Well, duh.
She would make comments about my eating disorder in front of many other patients, too, which is breaking HIPAA laws. “When you don’t feed, your body feeds on itself,” she would tell me with about 4 or 5 other patients present. They would snicker.
I once told her that I could never eat peanut butter again because it was my best friend’s favorite food and she died on May 1. I explained it was too painful for me because it was the food that we always ate and enjoyed together. I should not have told her this because she made it her mission to force me to eat peanut butter. She’d leave it lying around in my room when I was asleep along with graham crackers and I’d wake up in the morning and there it would be on my dresser. I’d cry because the sight of it made me miss Amanda so much. One time I did eat it in front of her just because she wouldn’t stop trying to force me to eat it. It tasted like grief and sorrow and loss, and she told me it was going to taste like fond memories. I cried the whole day the next day.
About a week later, I chose to eat peanut butter on my own, for some reason. The emergency medications they would give me would often make me crave it and I’d eat it without thinking about it. The psychiatrist pulled me aside when he heard about this.
“One of the staff says you’re being manipulative because you made this huge deal about not eating peanut butter and now you’re eating it.”
“I don’t see how that’s being manipulative. I didn’t want to eat it when forced but then I later decided to eat it on my own.” It didn’t take a genius to know which staff that was.
Another time I woke up extremely confused and I genuinely didn’t know where I was. I stumbled out of my room and limped into the common area and there was Brenda.
“Where am I?” I asked.
“I think you know exactly where you are and you’re trying to manipulate me,” she declared.
Confused, I stumbled back into my room and went back to sleep and never mentioned that incident again.
“HERE’S HOW YOU HANG YOURSELF”
Quite possibly the worst incident at Bemidji was when a staff member instructed me on how to hang myself. I don’t remember his name, but I remember his face very clearly.
I was very distraught that day and was in my room sobbing because I hated it there and I would do anything to leave. A staff came in and I told them, “I would do ANYTHING to get out of here! Absolutely ANYTHING!” They took this statement to mean that I would kill myself to get out of there, so they came in and removed everything from my room, including my pillowcases. A male staff member remained in my room with me.
“Why would they take my pillowcases? What the hell can you do with a pillowcase?” I wondered, genuinely confused.
“Well, you can hang yourself. I’ve seen a man do it with one pillowcase. He tied it up on the ceiling and tied it around his neck and hung himself.”
“Thanks for the tip,” I said dryly.
THE MEDICAL NEGLECT
This is the part that is the most difficult for me to write about. I cannot tell you how much it scared me.
I struggle with severe hypotension, or low blood pressure. When I first got there, they were taking my blood pressure three times a day. After a couple days, they reduced it to once a day. I confronted them about this and they said it was a “mistake.” They continued to do it twice a day but never three times a day again despite how low it often was.
They did labs twice weekly but never told me the results despite it being my right to know. At one point I did demand they tell me and they explained to me that I was deficient in several nutrients and they told me that they weren’t going to replace them or do anything about it.
“Why didn’t you TELL me my labs were bad?” I asked.
“That’s not something we would tell you,” they responded.
They’d force me to eat and I’d force myself to throw up to the point where I was vomiting blood. I showed them the blood in my vomit and they’d make comments such as “Well, we’re not going to do anything about that since you do it to yourself.” I asked them if they could talk to me a little bit after meals so that I didn’t feel the need to do this but they refused. I now have permanent stomach issues due to the lack of medical treatment I received there.
The psychiatrist, Dr. Erickson, promised me I would be able to stay on my Topomax, which prevents flashbacks and other PTSD symptoms, if I ate. I took his word at face value and I did, but he lied. He took me off of it without telling me.
The last two weeks I was there, I noticed I was feeling more and more depressed and I didn’t know why. After awhile I finally realized that my antidepressant was missing from my meds. I asked them about this and they said, “Oh, sorry. We forgot you were on it and stopped giving it to you. We’ll restart it.” There is absolutely no excuse for that. I have no words for how incredibly negligent that was.
BODY IMAGE COMMENTS
Anyone who works in mental health knows not to make comments on someone’s body image, or so I thought. Despite the fact that I was throwing up everything they forced me to eat, I was still gaining weight and it was obvious to some staff members and they felt the need to comment on it.
I was waking up one morning, and a staff member named Jody came into my room and started commenting on my body image out of the blue.
“It’s very obvious you’re gaining weight. Before you just looked way too thin and now you have a runner’s build and I really like it. Keep it up!”
Devastated, I clutched my blanket and sobbed.
Another time, when I was out in the common area, a staff member named Susie looked at another patient and looked at me and said to the other patient, “You’re so tiny!” I reported this comment to the supervisor but Susie lied about it and said that she had told “Ellie” that she had a tiny wait time for her next placement. That’s definitely not what she said but of course they were going to take Susie’s word over mine.
YOU CAN’T EAT, BUT HE CAN
There were times when I was ravenously hungry and I needed the nutrients but the staff refused to let me eat. They’d let Donny eat whenever he wanted, however. The dietician had ordered me vanilla pudding because it was mushy and easy for me to eat.
I asked for a snack and they said “No, you’ve had enough,” even though all I had for dinner was a small salad and I was really hungry. Donny came out of his room 5 minutes later and asked for food and they gave him the pudding that was ordered for me right in front of me.
“HEY! That’s MY pudding! The dietician ordered it for me special! And why shouldn’t I be allowed to eat when I’m hungry?”
The staff member Sarah aggressively told me, “That’s not YOUR pudding. And you’ve had enough to eat tonight. HE hasn’t.” That IS one thing that the staff got in trouble for when I reported it. It was communicated across the board that whenever I was hungry I should get to eat.
CREDIT WHERE CREDIT IS DUE
There were good staff there and I’d like to give them credit where credit is due. I don’t think I would have made it through if it weren’t for the good staff.
Mary Lou was my favorite. She’d pull me aside and talk to me and every time I had a complaint about the way one of the staff members were treating me, she’d address it. She assured me they wouldn’t let me die if I didn’t eat, although it was stuck in my mind after the one staff member had told me that. She often made me coffee with whipped cream and it tasted really good.
One night I passed out cold on the floor and they didn’t find me for 30 minutes or longer. The staff who took me to the ER was Chrissy. She was so sweet and kind and talked to me like one would talk to a friend. She would hug me every once in awhile and say, “We all need that physical contact. It helps.” And it did. The most difficult part of being in the hospital for me is the lack of physical contact so I appreciated it more than she will ever know.
Kaya was the best nurse they had there. She rescued me when the staff members were crowded around me laughing. She took me into her office and gave me a shot so that I’d fall asleep and stop crying. If I was hungry she’d feed me even though she wasn’t supposed to. She called herself the “food enabler.” She said she was always there and that I could come up to her whenever I needed anything so I really trusted her.
Farin Rae was the one who had experience in eating disorders. She was always telling me that I was beautiful and that I didn’t have to hate myself so much. She would sometimes have hour long conversations with me about my life and my struggles. She was genuinely interested in what I had to say, which meant a lot to me. She would gently encourage me to eat, rather than force and threaten like the rest of the staff did. I always looked forward to her coming in to work. She would print off special quotes for me so that I could hang them on my wall.
Tammy was my social worker there. She would make special time for me to work on my PTSD together. She’d devise special worksheets for me and I would do them and we would talk about them and how my PTSD had affected my life. Those sessions were very helpful for me and they were what got me through the day because I felt like I was doing something productive and not just languishing around doing nothing.