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Updates 2/17.

Torture (no access to outdoors): my Human Rights Complaint

The DMH directory for January 2025 says that Jeanne Crespi is the Person in Charge for Corrigan. I emailed my Human Rights Complaint to her.  She also is not acknowledging receipt of my email. When I don't get a reply, I try someone else.  So far, the people who have received copies of the complaint include: Jose Alfonso, Maxwell I. Mayer, Startrese Sims, the DMH ombudsman, and Lawrence Weiner.  Will anything happen?  I assume nothing will happen.  Someone will, based on clearly faulty reasoning, put it in a file for things that don't get attention.  The patients will continue not to be able to access the outdoors.  C'est la vie.

Corrigan History.

It was originally called the Fall River Mental Health Center.  I believe it was opened in the 1960s. 

At one point, it had 40 beds.

There was some controversy about Brown University allegedly getting paid for research it didn't do.

There was a larger-than-life psychiatrist there, Kennard C. Kobrin, who had lots of legal charges against him (pressuring female patients for sex, medicare fraud, running a pill-mill.  I hoped to speak to him, but, unfortunately, he died in 2020.  It seems he was largely vindicated.

Another public persona who is important in the Corrigan story is David B. Sullivan who is still alive. I have reached out to him to see if he could tell us about Corrigan and his career.  The outline is that he started out as a social worker at Corrigan. He then became a state representative and in that role worked to save Corrigan when it was threatened to be axed.  After his stint on Beacon Hill, he went to work in Fall River city government. In the Housing Authority or something like that. He eventually retired from that, and I do not know what he is currently doing. I looked up some email addresses for him and asked if we could ask him about his experience.  Probably nothing will come of it though. [Sigh]

In 2010, there were attempts to shut Corrigan down for budget reasons, and he protected it.  Incidentally, in press reports, it was said that Corrigan would lose 16 beds. So the reduction to 16 beds occurred prior to 2010.

Here is a good article about the fresh air law and when it was implemented. https://www.nepsy.com/articles/leading-stories/mass-dmh-releases-fresh-air-regulations/  The "fresh air" law was passed in January 2015, and the regulations I have been referring to went into effect in July 2016.  The article mentions that MGH applied for a waiver of these rules.  Back in October 2024, when I first became alarmed about the white, white skin of some of the Corrigan patients (how they never went outside), I assumed that Corrigan had a waiver. Specifically, I assumed it had developed a Plan which would detail why they couldn't provide outdoor access.  That is exactly what I asked Larry Weiner for. And it is what I asked Public Records for. Why do they not want to present this Plan?  I have no idea.  

Currently, the DMH is trying again to make progress on getting out of the inpatient psych business.  But Corrigan MHC appears to have escaped the axe. The plan is to cut another MHC, one in Pocasset.

My best interpretation of what is going on here: the way Corrigan is run is the way DMH is run. The ethic is one of CYA.  They pick a very small number of measurable outcomes they are interested in. For example, for Corrigan, the goals are (a) don't discharge to the street or to a homeless shelter; (b) pass accreditation, (c) no elopements, and (d) no suicides on unit.  When it comes to something like providing outdoor access, it simply falls by the wayside.  Likewise, therapy.  Social workers don't spend much time at all actually talking to the patients.  The fear, I guess, is that if they pay attention to other goals such as outdoor access, they will take their eyes off the CYA goals.  For example, outdoor access could lead to elopements.

Another example of this reduction to least common denominator is the new focus on falls.  You don't want falls, because that will make you look bad.  Why provide outdoor access when it will increase the likelihood of a fall? 

Philosophically, this is the essence of modernity.  One wants to eradicate "higher" goals. (Charles Taylor, 1995).

It is the same with DMH.  I don't know enough to be able to say what their CYA goals are. Avoiding lawsuits?  Avoiding negative press?  Avoiding the closure of facilities (i.e., empire defense)?  But whatever the least-common-denominator or CYA goals are, they seem to be disciplined at ignoring all goals based on principle.  Thus, if you look at the walls of any mental hospital, it will have significant space devoted to telling people that if they have the right to file a Human Rights Complaint.  The descriptions make it sound like a big deal.  Like you are really going to be able to have your voice heard.  But in reality, the Person in Charge is just someone who works there, and the Human Rights Officer too. They are people who are not incentivized to actually listen to and treat seriously any complaints.  

Two other examples are the ombudsman and public records.  If you look at the ombudsman's page, it sounds like they are really going to listen to you.  (They say they will get back to you in 48 hours!).  In reality, this is a higher goal which gets ignored.  Or we could say iby ignoring it, they justify the law itself, but not any particular application of it.  

For public records, they say they will get back to you, but they don't.  Transparency?  They don't even acknowledge receipt of emails.  This is not a matter of individual agression. It is, I assume, strategic and organized. I don't know (because they won't talk to me) but one hypothesis is that the upper staff tell the lower staff that issue X has become a legal matter. Once it has that label, then everyone is supposed to ignore it and the attorneys will deal with it.  It serves the "don't lose in court" goal, which is a CYA goal, at the expense of "higher" goals such as transparency and accountability.  Or so I suspect.  

------------

Two updates since I posted this audio.  Specifically, I sent two emails to Corrigan or DMH staff.  In the first, I asked for the plan again--this time I asked two other people in addition to LW.  I also expanded the request to include prior years.  In the second, I decided to go ahead and make an official Human Rights Complaint.  You are supposed to make a complaint to the Person in Charge.  I sent it to three people who, if they aren't that person, would certainly know who was.  Needless to say, I don't expect any of them to even confirm receipt of the email!!!

 

Here are the two emails:

substantive part of first email--asking for plan

Dear Ms. H, Mr. W, and Mr. G,

  I hereby request both the current version and all available prior versions of the written plan specified and required under 104 CMR §27.13(6)(f)5 for the inpatient unit at Corrigan Mental Health Center.   I hereby also request any and all documents and records pertaining to the DMH  determination of reasonable justification referenced referenced in 104 CMR §27.13(6)(f)(5)(c)(ii).      substantive part of second email--human rights complaint  

Dear Mr. W, Dr. M, and Dr. A,

I intend this email to constitute a complaint under 104 CMR, § 32.  My complaint relates to a longstanding condition at the Acute Inpatient Unit (IPU) at Corrigan Mental Health Center ("Corrigan"). I believe this condition is either dangerous, illegal, or inhumane. 

The condition relates to all Corrigan IPU patients other than those who are young, physically fit, and relatively social (the "Youthful" patients).  For example, it relates to those patients who are catatonic, obese, elderly, or who suffer from a physical handicap or a mental disorder such as social anxiety or claustrophobia (the "Compromised" patients).

Corrigan staff represent that the patients have four times that they get to go outside. But there seems to be little or no concern or recognition that only the Youthful patients take part in these breaks.  The Compromised Patients can spend days, weeks, and even  years without ever accessing the outdoors. 

[Consider, e.g.,] patient D, who was an elderly man with significant social anxiety.  In speaking with him, his favorite moments were the times he would take walks with his sister and look at flowers.  Yet as a resident at Corrigan IPU, he was too socially anxious to go to lunch, much less to go with the group for outdoors.  [Yet if someone dedicated themself to taking him outside, he greatly enjoyed and benefited from it.]

[But for a staff member's taking it on themselves to encourage him to access the outdoors] however, he would never have gone outside.  For practical purposes, for this patient to go outside, it is not sufficient to simply post outdoors times.  Given his complex condition, and given the physical plant at Corrigan, for practical purposes, he would not have gone outside at all during his time there but for a person encouraging him and following through.

Patient P has been a resident for perhaps two years.  [Again, a special effort is required to take P outdoors, and staff is highly resentful and obstructinist when someone takes the effort.  Staff would rather use the outdoors break as their own outdoors break, without having Compromised patients interfering.  Once, it was impossible to take P down, and staff purposively blocked her participation.  Yet there were three staff outside, and only two (Youthful) patients. Nevertheless, the explanation was that P could not access the outdoors due to ... "we don't have the staff"]. 

Essentially, there is a great deal of resistance to taking [Compromised] patients outside.  [Social worker D.K. is in a position of authority but is highly resentful of any efforts to change practices.  She seems to believe that because of her managerial position, she is beholden to defend the status quo.  She does not have the experience or magnanimity for her job and appears to have been promoted too early.]

Patient L, who was catatonic, probably never accessed the outdoors [although when asked, SW D.K. blithely asserted that he gets outside often.  Just because you are management does not mean you have to lie or dissemble for the sake of the official version.]

Accessing the outdoors is a human right for all detainees.  Under Massachusetts law, access to the outdoors has to be either individual or group access.  I do not believe that Corrigan offers individual access.  Other psychiatric hospitals, such as Southcoast Behavioral, are built so that it is easy to access the outdoors.  With Corrigan, it has to be done in a group and down two dark, steep staircases.  It is a forbidding prospect [for Compromised patients].  I understand that that is a physical plant issue, but if outdoor access is not provided, it is necessary that Corrigan have a plan for why this is not possible, and that plan has to be approved by DMH.  

In October, I asked Mr. W. for a copy of this plan.  I offered to help him revisit it.  I never heard back from him, and DK provided no support for my initiative.  [She is reckless and causes significant harm to actual people in apparently supporting what she believes are "rules" but often appear to be simply what-we've-always-done. As we know from Hannah Arendt, evil is not flashy; in practice in the world, evil is banal.  And in America, served with a complacent smile.]

I hope that this Complaint will serve to alert staff to the problem of outdoors access. Not being able to access the outdoors is considered a form of torture. There are important efforts to ensure that penitentiaries provide outdoor time to their inmates.  The law--and common humanity--requires the same opportunity be provided to residents of psychiatric IPUs.

  Original post:

The first time I encountered the de facto policy that DMH employees don't respond to emails, was on Halloween 2024.  I wrote an email to the "Human Rights Officer" [LW] at Corrigan asking whether I could help by bringing a fresh eye to the facility's outdoors policy.  I received zero reply. 

I have reprinted my email below.  It refers to the CMR (Mass. code of regulations).  So let's first get oriented to that. 

That Halloween email is quoted below.  In that email, I quote some from the Massachusetts Code of Regulations (CMR).  So let's consider the CMR first.  

The first five sections of the CMR are:

101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES 102 CMR - OFFICE OF CHILD CARE SERVICES 103 CMR - DEPARTMENT OF CORRECTION 104 CMR - DEPARTMENT OF MENTAL HEALTH 105 CMR - DEPARTMENT OF PUBLIC HEALTH

We are interested in 104.  Within 104, the first five sections are: 

104 CMR 25.00 - Authority, Mission, And Definitions (§ 25.01 to 25.04) 104 CMR 26.00 - Organizational Structure and Citizen Participation (§ 26.01 to 26.03) 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES (Subpart A to D) 104 CMR 28.00 - Licensing and Operational Standards for Community Services (§ 28.01) 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals (§ 29.01 to 29.16)

We are interested in 27.  Within 27, there are four subparts: 

SUBPART A: SCOPE AND DEFINITIONS SUBPART B: LICENSING SUBPART C: OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES SUBPART D: OPERATIONAL STANDARDS FOR SUBSTANCE USE DISORDER TREATMENT FACILITIES

We are interested in Subpart C, which has 13 subsections, including:

§ 27.11 - Periodic Review § 27.13 - Human Rights § 27.14 - Human Rights Officer; Human Rights Committee § 27.15 - Absence without Authorization

We'll be looking here at 27.13 and specifically sub-section (6)(f) which states: "A patient of a facility ... shall have reasonable daily access to the outdoors."" 

There are six subsections to § 27.13(6)(f) which elaborate on this reasonable daily access.  Three are relevant here (sub sections 1, 2, and 5). 

Sub section 1 says what is meant by "reasonable daily access." We are told it means "supervised or unsupervised daily access to the outdoors, individually or in groups." The word "individually" piqued my interest because Corrigan does not provide individual access.  In addition, this section says that facilities can establish designated times for access, "as long as each patient has a reasonable opportunity to access the outdoors on a daily basis ... during one or more of" those schedule times.

Subsection 2 is about how to construe "outdoors." Specifically, "outdoors" means "a space or area outside of a building, which may include a porch, courtyard, roof deck or open space surrounded by a building." Subsection 5 is about how the facility needs to have a plan. 

My Halloween email to LW was pretty tame.  I simply noted that it doesn't seem like the Corrigan IPU patients have access to the outdoors.  And I asked to see the plan.  I assumed that would answer all my questions.  Here is the email:

 

---Beginning of Halloween 2024 email to Human Rights Officer LW regarding outside air and outside light.----------------

"I am writing to ask if I could help assist you / your office in conducting a fresh-eyed review of Corrigan Inpatient's compliance under 104 CMR, §27.13(6)(f) (reasonable daily access to the outdoors). 

Although Corrigan Inpatient does schedule Recreation breaks (at 8am, 1pm, 4pm, and 8pm), it is my understanding and belief that some patients, especially elderly patients or largely bedridden patients, do not in fact take advantage of these breaks.  ... 

On three occasions, I prompted elderly patients to go to on one of these outside breaks. On two of those occasions, my efforts were successful, and I believe the patients greatly benefited.  [Yet to my understanding, this trip outside was rare for these individuals,] causing me to wonder whether some patients would *like* to take advantage of the outside but are intimidated by the current structures of these breaks.  

For example, note that under 104 CMR, §27.13(6)(f)(1), "reasonable daily access ... mean[s] daily access to the outdoors, individually or in groups" [my emphasis].  I do not believe that Corrigan Inpatient offers individual access. Yet, for many IPU patients [e.g., those with paranoia, social anxiety, obesity, or catatonia], the only way they could reasonably be expected to access the outdoors would be via individual access]. 

Admittedly, it may not be possible or feasible to offer individual access, but my aim is to help assist you and Corrigan Inpatient in taking a fresh look at this issue. ...

To start, could you please provide to me (or point me towards) the written plan described in 104 CMR 27.13(6)(f)5?  That may answer all my questions.  I look forward to working with you on this important issue.  

The Association for the Prevention of Torture, for example, recommends a minimum of one hour outdoor exercise for any detainee [https://www.apt.ch/knowledge-hub/dfd/outdoor-exercise].  The benefits of exercise and sunlight for mental health are very well established. 

I would be happy to discuss these issues in person at at any point.  

-------End of Halloween email

No response. Zip.  Not even acknoweldgment of receipt.  I did, however, re-send this email to LW yesterday (February 7, 2025).  Note that despite being significantly over-staffed, the answer to the question, "Why don't you provide individual access?" will probably be: "we don't have the staff for that."

It will also be pointed out that the building is old, and it is not feasible to provide secure access: partly due to the unreliable elevators and partly due to the fact that to access the outdoors from the unit, it is necessary to walk down a long and narrow stairway.  That is certainly understandable. 

Nevertheless, the CMR specifies that if the facility cannot provide access, they simply need to document it in the plan. Here is the code regarding that plan.  Section c is the part saying that if staffing or the physical plant preclude satisfying the requirements, then you simply add that to the plan.

--------BEGIN EXCERPT FROM CODE REGARDING THE PLAN THE FACILITY MUST KEEP-----------

a. The plan shall include the following: i. procedures, including staffing and other safety requirements, to allow for access to nonsecure outdoor space for patients who have been assessed as clinically appropriate and safe to exercise this option; and ii. procedures, including staffing and other safety requirements, to allow for access to secure outdoor space, if available, for patients who have been assessed as clinically appropriate and safe to exercise this option.

b. Reasonable efforts to safely provide access to outdoor space may include, but shall not be limited to: i. reasonable capital expenditures to develop, construct or otherwise acquire outdoor space; ii. reasonable modifications of staffing patterns to permit staff escorts; or iii. reasonable modificationsto building access policies to permit patient access to common areas of the facility or proximate to the facility not normally dedicated as patient areas.

c. If the facility determines that it cannot safely provide secure outdoor access due to staffing or physical plant limitations, it shall: i. identify and document such limitations in the plan; and ii. identify what actions the facility will take to address these limitations and the time frame for the actions. If the facility determines that the limitations cannot be reasonably remedied, the facility shall identify the reasons for such determination. Such reasons shall be documented with sufficient detail to enable the Department to determine whether they constitute reasonable justification.

d. Upon request of the Department, but no less frequently than in its application for licensure or license renewal, the facility shall demonstrate to the Department’s satisfaction that its plan is current and that it has identified, considered and implemented all reasonable actions to safely provide access to outdoor space.

--------END EXCERPT FROM CODE REGARDING THE PLAN THE FACILITY MUST KEEP ------------

That was 27.13.  The next section is also relevant. It's about how the Human Rights (including the right of access to the outdoors) is (supposedly) enforced.  It doesn't look promising, but here it is:

27.14: Human Rights Officer; Human Rights Committee

(1) Human Rights Officer. Each facility shall have a person or person employed by or affiliated with the facility appointed to serve as the human rights officer and to undertake the following responsibilities: (a) To participate in training programs for human rights officers offered by the Department; (b) To inform, train and assist patients in the exercise of their rights; (c) To assist patients in obtaining legal information, advice and representation through appropriate means, including referral to attorneys or legal advocates when appropriate; and (d) In the case of Department facilities, to serve as staff to the facility’s human rights committee. The human rights officer must have no day-to-day duties that are in conflict with his or her responsibilities as a human rights officer, including carrying out fact-finding activities under 104 CMR 32.00: Investigation and Reporting Responsibilities.

2) Human Rights Committee. For each facility operated by, or under contract to the Department, the Commissioner or designee shall establish, impanel and empower a human rights committee in accordance with the provisions of 104 CMR 27.14. Such a human rights committee may be established jointly with other programs in an Area; provided however, that the number, geographical separateness or programmatic diversity of the programs is not so great as to limit the effectiveness of the committee in meeting the requirements of 104 CMR 27.14. (3) The majority of members of each human rights committee shall be current or former consumers of mental health services, family members of consumers, or advocates; provided however, that a member who has any direct or indirect financial or administrative interest in the facility or the Department shall notify the facility director or Commissioner, as applicable, in writing. (4) The general responsibility of each such human rights committee shall be to monitor the activities of the facility with regard to the human rights of the patients in the facility. The specific duties of the committee shall include: (a) Reviewing and making inquiry into complaints and allegations of patient mistreatment, harm or violation of patient’s rights and referral of such complaints for investigation in accordance with the requirements of 104 CMR 32.00: Investigation and Reporting Responsibilities; (b) Reviewing and monitoring the use of restraint, seclusion and other physical limitations on movement; (c) Reviewing and monitoring the methods utilized by the facility to inform patients and staff of the patient’s rights, to train patients served by the program in the exercise of their rights, and to provide patients with opportunities to exercise their rights to the fullest extent of their capabilities and interests; (d) Making recommendations to the facility to improve the degree to which the human rights of patients served by the facility are understood and enforced; and (e) Visiting the facility with prior notice or without prior notice provided good cause exists.

(5) Each such human rights committee shall meet as often as necessary upon call of the chairpersons, or upon request of any two members, but no less often than quarterly. Minutes of all committee meetings shall be kept and shall be available for inspection by the Department upon request. The committee shall develop operating rules and procedures, as necessary.

 

 

 

The American Bar Association, the U.N. Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules), and the Association for the Prevention of Torture all recommend a minimum of one hour outdoors daily, weather permitting, as part of minimum humane standards for detention and incarceration.

-------------------------------------

This is a 2nd podcast about the IPU (inpatient unit) at Corrigan Mental Health Center.  There are many other things going on at Corrigan MHC besides the IPU.  For example, there is a great program for helping families in which there is a young person who may be experiences the early stages of psychosis.  The people there are excellent. This podcast is only about the IPU.

In brief, the IPU itself is a valuable entity for the community.  If you did not consider the taxpayer perspective, there would be little to find fault with.  Once, however, you do consider the taxpayer perspective, you start to see Corrigan IPU in a very different light.  On the surface, it looks like a place to treat people who are a danger to themselves or others, albeit one that is substantially overstaffed.  From the taxpayer perspective, however, we look at the underlying reality: where is the cash going?  Who is receiving the cash?

And the answer is that from this perspective, Corrigan IPU is a benefit program where labor-market subsidies are suppled to a group of white, middle-class professionals.  For a population of at most 15 or 16 patients at a time, we have a staff of 30? 40? middle-class white professionals  working for whom Corrigan IPU provides employment safe from labor market presures.  The IPU may also effectively provide a private IPU for the patients of providers working there. 

I wanted to get some data or records to confirm or deny my understanding.  I wanted to know how did we end up with such a small unit with so many professionals working there?  So I first tried to make a public records request.  The folklore was that it was a patient suicide which caused the dramatic downsizing (but not the elimination) of the unit.  I wanted to find out when that suicide had occurred. The public records request put me in touch with a very nice young person who referred me then to the Director of Communications (DOC).  They may have the data I need at their fingertips.  I expanded my request and sent it to the DOC.  

That was mid January. By early February, I had received nothing back. Not even an acknowledgement of receipt of the email. So on Feb. 3, I left two voicemails and re-sent the original email.  As of February 7, today, still I have received nothing.

This was my experience also when I wrote the Human Rights Director originally to ask how Corrigan IPU justified its practically minimal provision of outside air and outside light to patients. (Effectively, on information and belief, only about 1/4 to 1/3 of the patients there receive daily outdoor air and light.  None are provided with individual access to the outdoors).  When I wrote the HRD, I received nothing, zip back.

There are laws and then there is what happens. My guess would be that DMH employees face incentives which make it inadvisable for them to reply to non-fluff inquiries.  It seems like it will only lead to frustration to keep communicating with the DOC.  So all I do, below, is provide the email chain with DMH.

1. At first, I was simply interested in trying to verify the folklore, viz., that the unit's bed count was cut dramatically following a patient suicide.  I wanted to know the date of that suicide, so I sent this request on January 11: 

I request all documents related to any patient suicides at Corrigan Mental Health Center in Fall River, from 1990 to the present.

2, They replied: 

Thank you for your email.  Kindly let me know when you have a moment to speak about your request over the phone this week. Our office hours are M-F 9 am to 5 pm.

3, We spoke on the phone, and I was diverted via this email: 

Thank you for your conversation today, where we went over your request and concluded that you were looking for information and not records regarding capacity at CMHC. Given this, we agreed to withdraw your request and to connect you with our Director of Communications, [GH] to go over your inquiry about that information and how it is reported. I have copied her contact information below.

[GH]

617-626-8150

4, I then called the Director of Communications (DOC), and I got the sense from the outgoing message that the phone number was more of a voice message collection device. (It was doubtful would ever be actually answered). The outgoing message also indicated people should email the DOC.  I expanded my request and sent the following email to the DOC on Friday January 17th:

  Hi.  I am planning to do a series of podcasts about the Acute Inpatient Unit Corrigan Mental Health Center in Fall River ("Corrigan IPU).  (If you are interested, the first of these podcasts is here: https://philosophypodcasts.org/pork, but you don't of course need to listen to that.  I merely provide it in case you are interested. )  I wrote a records request (below), but Mr. [G] steered me instead towards you, suggesting you may be in the best position to answer my questions.  The major puzzle I have is the following: It seems that the Corrigan IPU has only 16 beds.  Despite the fact that these are non-violent, non-medically compromised patients, there are more professional staff than patients.  On information and belief, the Corrigan IPU once served a much larger caseload.  (Specifically, at one time, it held 40 patients).     Questions 1) Is it correct that the the Corrigan IPU only has 16 beds 2) Is it correct that the Corrigan IPU employs many more than 16 professionals (specifically, is it correct that Corrigan IPU employs over 10 nurses (including two in administrative positions--i.e., who do not interact with patients, but merely serve as administrators of the staff), 1 nurse practitioner, 1 MD, 3 full-time social workers, 2 full-time occupational therapists, a dietician and a peer-support specialist?   3) Is it correct that all of these professionals are white (i.e., caucasian) 4)  Is it also correct that the Corrigan IPU also employs at least 12 mental-health workers?  5)  Is it correct that all of the higher-level (level 3 or 4) mental health workers are white?  6) Is it correct that Corrigan IPU also employs a doctor-on-call around the clock? 7)  Including all staff, what are the annual labor costs for operating the Corrigan IPU? 8)  Is it also correct that Corrigan IPU does not track whether its patients access the outdoors?   9) Is it correct that patients do not have the opportunity to access the outdoors individually? 10) Is it correct that the patients can only access the outdoors in groups, and only by traversing staircases that are daunting for older patients? 11 Is it correct that the Corrigan staff does not require or even encourage patients to access the outdoors? 12) Does the Massachusetts DMH agree that not being able to access the outdoors is a form of torture?

5. After a couple of weeks of not hearing anything, I decided to attempt contact again. On February 3rd, I left a voicemail message with the DOC asking if she had received my email and asking if she could call me or email me at least to confirm receipt.  I also sent them an email forwarding the Feb. 17 email.  

Dear [DOC],

I hope you are well.  Could you please confirm that you received this message?  I just want to make sure it didn't slip through the cracks!   Thank you so much.   As of Feb. 7 2025, I have received neither a phone call nor an email in reply.  

 

 

Wouter Kusters

A Philosophy of Madness: The Experience of Psychotic Thinking

MIT Press: https://mitpress.mit.edu/9780262044288/a-philosophy-of-madness/

See https/://CorriganIPU.com for updates on Human Rights Complaint submitted to Mass DMV regarding alleged human rights violations in this Fall River, MA facility.

Corrigan IPU patients deserve a real, substantive right to access the outdoors.

It is gross really to see the Corrigan IPU patients staying inside day after day, week after week, and in some cases month after month. And it is still more alarming when Corrigan staff blithely and complacently point to the four times a day when a minority subset of patients (youthful patients) can go outside. (Roughly 25% to 50% of patients [depending on the patients on unit at a particular time) can access the outdoors because, for example, they do not suffer neither obesit], paranoia exacerbated in groups, social anxiety, catatonia, or dementia, and do not present fall risks). For the other patients (the majority [especially when weighted by length of stay]). they are inside constantly, and it is disgusting to see. Their skin can be as white as white-out. The outdoors breaks are valued by the employees, but the employees aren't able to extend the courtesy to their fellow humans.

It is a case of domination of the medical professionals over the neurodiverse. Some Corrigan staff no doubt get off on this. Most would get off on it indirectly and subliminally. Maybe a few get off on it consciously and directly.

On the other hand, there is also another factor at play: the way we can get used to things that are odious, simply because others aren't clamoring about it, and we simply stop paying attention. If you went to Corrigan IPU, you would be appalled by the majority of patients who never go outside. But I venture if you shunned it for a year or so, you would eventually get used to it. You would be able subconsciously to suppress how disgusting it is for these humans (who happen to be patients) to be tortured by not having a real substantive, right of access to the outside. How does this happen? Rousseau in his Confessions said it was human nature.

"I have derived an important moral principle, perhaps the only one of any real practical use, which is that we should avoid situations that bring our duty into conflict with our interests … since I am certain that in such situations, … we will sooner or later weaken, without noticing it, and become unjust and wicked in deed without having ceased to be just and good in spirit"

I first raised this issue with Corrigan in October 2024 to Larry Weiner who is the Director of Human Rights at Corrigan. He simply ignored me. Danielle Keogh, LICSW, actively resisted my efforts. I then decided to make a formal Human RIghts Complaint. I assumed this would get a response. However no one from Corrigan would even acknowledge they received it. I sent it to:

Jose Afonso ("provider" where a "provider" is sometimes called a "prescriber". It is essentially someone who can prescribe, so it is a nurse practitioner, DO, etc.)

Maxwell I. Mayer (provider)

Larry Weiner

and Jeanne Crespi, social worker.

Nb: I have invited each of these people to come on to this podcast or contact me in writing to correct me where I am wrong.

To work at Corrigan you need to develop the ability to shun. You shun recognition of how many patients don't get to go outside. You shun the nausea you probably had when you first saw this. You also learn, it seems, to shun other people, people such as me who are raising the issue. A social worker or mental-health counselor would in fact claim that such shunning constituted "self care" or "an adaptive coping mechanism."

Until they correct me, I would attribute Afonso and Mayer's non-response to their occupational or characterological contrariness and sense of superiority. They are "providers." They also have a vested interest (which is subliminal [see Rousseau]) as they possess the big swinging dicks at Corrigan IPU, are used to being kowtowed to, and, on information and belief, seem to use the Corrigan IPU as the IPU for their personal (presumably middle-class, white) patients. (The nurses will hold a bed open when they know that one of the providers' patients will soon be needing a bed. On information and belief, they also keep their own patients there longer ceteris paribus.

Also as the golden goose: Corrigan IPU apparently requires an MD be on call all the time in case of an admission.

The upshot is that it is good to have one of them as a provider. From the perspective of their patients' families, keeping this small (16-bed) unit open is a godsend. It only starts to look sketchy when you think of the anonymous payers of taxes and insurance premia.

Why did I send it to Jeanne Crespi? She is the interim "Person in Charge," meaning she is the person you are supposed to contact with a Human Rights Complaint. It was thus quite surprising to me that neither she nor Larry Weiner even acknowledged my Complaint, or were willing to indicate to me that my Complaint would be taken seriously. I mean: that is one of their official, professional duties, as the Human Rights Officer and Person in Charge.

In each case I was specifically--and increasingly plaintively--asking that they person please acknowledge receiving my Complaint, as a matter of simple courtesy.

To no avail. Repeatedly shunned, I felt myself in full Karen mode. I went up the chain of command until, finally, I reached Star Sims, JD, Director of Human Rights for all of DMH. I appreciate attorney Sims responding quickly and professionally, acknowledging receipt of my complaint.

Below are:

(I) my exchange with Attorney Sims

(II) timeline dates, factoids, and gossip mentioned in the podcast

(III) my letters to Corrigan staff (each of which was met with the silent treatment)

(I) my exchange with Attorney Sims

On Tue, Feb 18, 2025 at 9:38 AM Sims, Startese (DMH) wrote:

Good Morning Mr. [sic] Baker,

I am acknowledging that I have received your email. I have forwarded your email/complaint to the DMH Office of Investigations for processing. The Human Rights Office does not investigate complaints.

Thank you, Star

Star Sims, J.D. Director of Human Rights Department of Mental Health 25 Staniford Street Boston, MA. 02114

From: August Baker Sent: Friday, February 14, 2025 6:58 PM To: Sims, Startese (DMH) Subject: Human Rights Complaint

Startese Sims, JD/ Director of Human Rights / Massachusetts Department of Mental Health

Dear Attorney Sims,

It is well-known that all detainees should be provided at least one hour daily of outdoor air and outdoor light. This is for example the longstanding and well-established position of the United Nations (as codified in the Nelson Mandela Rules). If a facility does not provide daily outdoor access, that is considered a form of torture (e.g., the Association for the Prevention of Torture).

Massachusetts state law and state regulations concur. A patient of a facility must be provided daily access to the outdoors, individually or in groups. 104 CMR §27.13(6)(f)

I hereby make this Human Rights Complaint regarding the Acute Inpatient Unit at Corrigan Mental Health Center ("Corrigan IPU"). Although the percentage varies depending on the current patient load, a significant portion of the patients at Corrigan IPU are not provided a substantive right of daily access to the outdoors. As a result, based on information and belief, many patients at Corrigan IPU can go a whole week without accessing the outdoors. Some can go even an entire month without access. The staff at Corrigan IPU do not even keep track of when was the last time that a patient accessed the outdoors.

I have the right to make this Complaint and have it be taken seriously. Under Massachusetts state law and regulations, any person may make a Human Rights Complaint regarding a condition involving DMH clients which he or she believes to be dangerous, illegal, or inhumane. 104 CMR, § 32.04

That is precisely the situation here I am complaining about a condition involving DMH clients which I believe to be both illegal and inhumane. Yet I have attempted several times to bring this condition to the attention of Corrigan personnel, and their response has been to ignore my complaint. I first brought the issue to the attention of Human Rights Officer Lawrence Weiner in October 2024. I recently made my complaint known to Facility Medical Director Jose Afonso, and staff member Maxwell Mayer. I also made it known to Jeanne Crespi, who, according to the January 2025 DMH Resource Directory, is the current Person in Charge.

In addition, I have made public records requests regarding this issue. (I asked, specifically, for any information regarding a Plan as defined in 104 CMR 27.13(6)(f)5. I also contacted the Ombudsman. In all cases, there has been no response at all.

It appears that DMH has a policy of ignoring correspondence. I have no reason to believe that my Complaint is being taken seriously. Could you please acknowledge receipt of this email? Could you also please be sure that someone is taking this complaint seriously?

Thank you so much,

Sincerely,

August Baker, PhD

(II) timeline dates, factoids, and gossip mentioned in the podcast

We start with the Kennedy Administration Mental Health Centers Act. The first MHC in the state was in Lowell, and the second was the Fall River Mental Health Center. It started out in 1961 as an annex of Taunton State Hospital and was located within Charlton (then known as Union) hospital. In August 1962, it moved to a remodeled laundry building at 680 Maple St., adjacent to its future location on Hillside Ave, which was then under construction. The Hillside Ave building originally had a 40 bed IPU on the top floor. It was renamed after a cardiologist, Dr. John C. Corrigan, in 1970.

From 1992 to 1995, the Weld administration attempted unsuccessfully to privatize Corrigan. In 1992, most Emergency Services provision was privatized in the state, but Corrigan and Pocasset remained under DMH control.

2010 press reports indicated that a closure of Corrigan was prevented by the efforts of legislator David B. Sullivan, who started his career as a social worker at Corrigan. It was said then that 16 beds would be lost. I infer that the reduction to 16 beds occurred prior to 2010.

2015 Southcoast Behavioral in Dartmouth opened as a joint effort of South Coast Health and Acadia Healthcare of Franklin Tennessee. It opened as a 77,000 square foot, 5-unit hospital with 24 beds per unit. Thus, initially, it had 120 beds. It has since opened three more units. Thus, it is up to 192 beds. As noted in the podcast, what is striking is to compare the professional staff at Southcoast Behavioral (with its 200 patients) compared to 16-bed (!) Corrigan. Southcoast Behavioral no doubt has many more techs than Corrigan IPU, but it has far fewer techs per bed. It is run entirely by nurses. That is, nurses do all the work, compared with Corrigan which has redundancy between OT, Social work and the nursing staff. Even the OT staff at Corrigan feel the need to insert themselves into treatment planning generally (not simply with respect to OT). Southcoast Behavioral is built ranch-style, we might say. Every unit has direct same-floor access to the outside. It is in this respect much more humane than Corrigan.

It also pays market wages and salaries, compared to Corrigan which pays labor-market rents to its unionized, public-sector workforce. That might sound like a good thing, but with labor-market rents comes discrimination. The Corrigan professional staff has zero African Americans. The Corrigan blue-collar staff is entirely white and male at the higher pay grades. There are a handfull of African Americans on the lowest end of the payscale.

On January 7, 2015, the Fresh Air law (S.911, H.3805) was signed by Gov. Deval Patrick. [See https://malegislature.gov/Bills/188/H3804 ] At the time, it was estimated that 25 to 30 percent of psychiatric hospitals would be unable to pass even the 2016 regulations which DMH promposed to operationalize the law. However those hospitals which were unable to comply were required to provide a plan to DMH indicating how they would remedy the situation. It is now 10 years later, and Corrigan has still not provided meaningful outdoors access to its most physically and mentally compromised patients. (It offers only nominal outdoor access. These are taken advantage of by its youthful patients and enjoyed also by the staff. Nothing wrong with that, but what about the compromised patients?) It is this plan that I have been trying to get. I originally asked Larry Weiner for it in 2024. He shunned the entire topic.

2017 Emergency Services at Corrigan were privatized resulting in savings of $6.4 million in the first year alone without a reduction in the level of services. Unlike the early 1990s, employees did not succesfully organize resistance to the move.

Kennard C. Kobrin was a psychiatrist at Corrigan until 1998. His background was in San Francisco, not Hollywood. He was married to the actress Joanna Cassidy, who described Kobrin as a "wonderful duality," "with doctors on one side and Janis Joplin, Jimi Hendrix and people who were selling clothes to Jefferson Airplane on the other." https://www.southcoasttoday.com/story/news/1999/04/11/trying-dr-kobrin/50529926007/

[IN PROGRESS]

(III) my letters to Corrigan staff (each of which was met with the silent treatment)

[IN PROGRESS]

See CorriganIPU.com for updates on Human Rights Complaint

The IPU at Corrigan Mental Health Center. This is a psychiatric IPU in Fall River, MA. It's a DMH facility.

Best parts:

1) there are some excellent staff members (excellent both for patients and for co-workers), (e.g., OT Kyle, providers Max and Allison, nurses Christian and Jill, tech Sean, Social Worker Nicole).

2) As a public-sector, unionized shop, the staff can be their authentic selves. For those who don't like their jobs, they can express that openly. They are not pressured to dissimulate.

3) for patients, if you are looking for a place to stay a while, (i.e., if you are okay with being detained longer than the usual 72 hours), and if you are young and hence able to access the outdoors space, it may be a good place. If you are a patient of one of the Corrigan doctors (like Mayer, then an advantage of having Mayer as a doctor is that he is able to use this unit as an IPU for his regular outpatient clients. He can keep them there in an emergency and thus provide a respite for the patient and their family, a chance to return to stabilization)

Worst parts:

(a) Approximately half of the patients do not have actual access to the outside. The staff will tell you they provide four outdoor opportunities per day. But for practical purposes, many of the patients cannot--orwould not be reasonably expected to--access the outdoors as provided by Corrigan. (To go outside requires negotiating a steep set of stairs [it can be possible to take elevators but the elevators are difficult to operate, the techs don't make them readily available, and even when the techs are asked to take someone down in the elevator, they may choose not to. ). In addition, accessing the outside can only be done in a large group. Many of the patients are anxious in groups and would love to access the outside if they were able to do so individually, but prefer not to go down in the crowded group, long-stair, way with chains and locks, and authentically depressed staff).

(b) Taxpayers lose big time. This is an extremely cost inefficient IPU. It is staffed 24/7/365, (including always an on-call provider apparently), and the staffing levels are such that, during the day shift alone, there are more staff than patients!!!

At one time, Corrigan IPU had 40 patients. The folklore is that a patient there hung themself and, as a result, the beds were dropped all the way to 16. But there are more than 16 staff working the day shift alone (not even counting the evening shift or nighttime shift). During the daytime, there are

5 nurses (a charge nurse, another unit nurse, a med nurse, and two nurses in an administrative role (not on unit).

2 occupational therapists

2 providers

4 techs

and 3 social workers

That is for 16 beds, and often a bed or two is empty, so let's say 15 patients on average.

In addition, there are other staff who are not full time (or who work full time, but divide their time across the IPU and other operations): a pharmacist, a nutritionist (she may be full time), a peer advocate, a human rights officer, and more layers of admin.

In addition, Corrigan tends to keep people longer than other inpatient units--- much longer (e.g., instead of 72 hours, one stays for months or even, for two patients, 2 years and counting). Because of this, there are more court proceedings compared to units which churn more on a 72 hour cycle. Few if any patients bring their own counsel. So whenever there is a hearing, the taxpayers are paying for the DMH attorney, the Corrigan Staff, the patient's attorney, and the judge or magistrate.

(c)

Danielle Keogh, LICSW is a reckless individual.

You would think that social workers would be people who will talk directly to anyone they have issues with. SW Keogh was incapable of doing this and, instead, recklessly tries to railroad subordinates by going behind their back and trying to squeeze them.

You would think that she, as a social worker, would be patient-centered. In fact, she claims the patients at Corrigan are not well enough for a patient-centered approach. Her priority appears to be her career and her title / her status. (How, one might ask did she get promoted to her current position after only a few years on the job? Pretty privilege? Who was making the hiring decision? Why do they like working with her?) Her focus is entirely on appearances and, in particular, looking good to bureaucrats. Her direction to her subordinates is to lie on MIS because her main priority is to do well in audits. That is, she wants to do well when she is evaluated from above. Her going behind subordinates' back and trying to clamp them down is the sign of someone who thinks that social work is about being a tool in a hierarchy.

You would think that she, as a social worker, might view social work as a place to create change and fight social injustice. But in reality, she deals with personnel matters unprofessionally--as a matter for gossip. Her view of what social work is about is doing whatever has no effect. For example, it is essential that social workers spend hours and hours--not actually talking with patients--but arranging post-discharge PCP appointments which, if you know anything about the patients, you know they will never attend.

She acts friendly to your face while going behind your back, and she lies to your face about it. She is unprofessional and insecure. She is reckless because she is dysregulated. It seems she holds anger inside, unwilling to talk with the person she is angry with. Instead, she takes it out by interfering with their lives. She is the sort of social worker who is essential a Karen. She thinks her role is to interfere in the lives of everyone around her because of her insecure attachment to some bureacratic rules she got somewhere. Very little integrity. She is not to be trusted. She is really disappointing. Or it is disappointing that whoever hired her and has been reviewing her has made her think the way she is in professional situations is ok.

Very disappointing to have met such a disingenuous, dishonest, insecure, unprofessional, disregulated person.

Overall. somehow when Southcoast Behavioral was created, Corrigan was not folded in. A staff of 50 to oversee 15 non-violent patients who don't have medical issues. The unit doesn't even track which patients actually get outside for outdoor air and outdoor light. On information and belief, about half of the patients never get outside, yet no accommodations are made. (Frequently, the reason given for not being able to make changes is, of course, "we don't have the staff." It should not be surprising that not one member of the professional staff is African American, and Dr. Mayer's patients (who comprise 20% of the population) are disproportionately if not entirely middle-class.

Be thankful you don't get the government you pay for.

Alenka Zupančič

Disavowal

This book argues that the psychoanalytic concept of disavowal best renders the structure underlying our contemporary social response to traumatic and disturbing events, from climate change to unsettling tectonic shifts in our social tissue. Unlike denialism and negation, disavowal functions by fully acknowledging what we disavow. Zupancic contends that disavowal, which sustains some belief by means of ardently proclaiming the knowledge of the opposite, is becoming a predominant feature of our social and political life. She also shows how the libidinal economy of disavowal is a key element of capitalist economy.

The concept of fetishistic disavowal already exposes the objectified side of the mechanism of the disavowal, which follows the general formula: I know well, but all the same, the object-fetish allows me to disregard this knowledge. Zupancic adds another twist by showing how, in the prevailing structure of disavowal today, the mere act of declaring that we know becomes itself an object-fetish by which we intercept the reality of that very knowledge. This perverse deployment of knowledge deprives it of any reality.

This structure of disavowal can be found not only in the more extreme and dramatic cases of conspiracy theories and re-emerging magical thinking, but even more so in the supposedly sober continuation of business as usual, combined with the call to adapt to the new reality. To disrupt this social embedding of disavowal, it is not enough to change the way we think: things need to change, and hence the way they think for us

Stijn Vanheule

Why Psychosis Is Not So Crazy

A Road Map to Hope and Recovery for Families and Caregivers

An expert's guide to humanizing psychosis through communication offers key insights for family and friends to support loved ones during mental health crises.

Are we all a little crazy? Roughly 15 percent of the population will have a psychotic experience, in which they lose contact with reality. Yet we often struggle to understand and talk about psychosis. Interactions between people build on the stories they tell each other—stories about the past, about who they are or what they want. In psychosis we can no longer rely on these stories, this shared language. So how should we communicate with someone experiencing reality in a radically different way than we are?

Drawing on his work in psychoanalysis, Stijn Vanheule seeks to answer this question, which carries significant implications for mental health as a whole. With a combination of theory from Freud to Lacan, present-day research, and compelling examples from his own patients and well-known figures such as director David Lynch and artist Yayoi Kusama, he explores psychosis in an engaging way that can benefit those suffering from it as well as the people who care for and interact with them.

Peter Singer

Consider the turkey

Why this holiday season is a great time to rethink the traditional turkey feast.

Maria Balaska

Anxiety and wonder

On being human

Description At times, we find ourselves unexpectedly immersed in a mood that lacks any clear object or identifiable cause. These uncanny moments tend to be hastily dismissed as inconsequential, left without explanation. Maria Balaska examines two such cases: wonder and anxiety – what it means to prepare for them, what life may look like after experiencing them, and what insights we can take from those experiences.

For Kierkegaard anxiety is a door to freedom, for Heidegger wonder is a distress that opens us to the truth of Being, and for Wittgenstein wonder and anxiety are deeply connected to the ethical. Drawing on themes from these thinkers and bringing them into dialogue, Balaska argues that in our encounters with nothing we encounter the very potential of our existence. Most importantly, we confront what is most inconspicuous and fundamental about the human condition and what makes it possible to encounter anything at all: our distinct capacity for making sense of things.

Table of Contents Preface Acknowledgments Abbreviations

Introduction

1. What Makes Us Anxious?

2. Anxiety and the Origin of Human Existence

3. Wonder and the Origin of Philosophy

4. The Paradox of Anxiety and Wonder

5. After Anxiety and Wonder

Notes Bibliography

Editorial Reviews Review "In this astute analysis of anxiety and wonder, Maria Balaska argues that understanding ourselves requires more than natural causal explanations and resists psychopathological approaches to overpowering experiences. With Kierkegaard, Heidegger, Wittgenstein, and Lacan, she insightfully elucidates the deeply human desires to feel at home in the world and find meaning in it-and the possibility of their fulfilment." ―Kate Kirkpatrick, Regent's Park College, University of Oxford, UK

"Maria Balaska presents the best treatment to date of wonder and anxiety in Kierkegaard and Heidegger. Focused on the objectlessness of both experiences – what Kierkegaard calls the ambiguous power of spirit and Heidegger terms "the nothing" – the book draws as well on Freud, Lacan, Plato, and Wittgenstein to argue that living authentically means embracing the liberating power of one's mortal open-endedness. Capacious, insightful, and written in lucid prose, Prof. Balaska's text will enrich both lay and professional readers.'" ―Thomas Sheehan, Professor Emeritus of Religious Studies, German Studies and Philosophy, Stanford University, USA

"Maria Balaska facilitates a conversation between Heidegger, Kierkegaard, Lacan and Wittgenstein that presents philosophy as embodying an anxious wonder at our capacity to make sense of things. She thereby deepens our understanding of all four thinkers, and illuminates not only the distinctive nature of philosophy, but its ineliminable role in the perennial human task of making sense of ourselves and our place in the universe." ―Stephen Mulhall, Professor of Philosophy, University of Oxford, UK

"This is an excellent book … A must-read for specialists interested in how continental philosophy can contribute to the thriving discourse on the experience and place of anxiety and wonder in our lives." ―Philosophical Investigations

About the Author Maria Balaska is a Research Fellow at Åbo Akademi University, Finland, and a Visiting Research Fellow at the University of Hertfordshire, UK. She is the author of Wittgenstein and Lacan at the Limit: Meaning, and Astonishment (2019) and editor of Cora Diamond on Ethics (2020). Publisher ‏ : ‎ Bloomsbury Academic (May 2, 2024) Language ‏ : ‎ English Paperback ‏ : ‎ 168 pages ISBN-10 ‏ : ‎ 1350302937 ISBN-13 ‏ : ‎ 978-1350302938

Deirdre Nansen McCloskey

Liberalism

By revealed preference, Prof. McCloskey is our favorite scholar to talk with. This is our third conversation with her. Today, we discuss two working papers on liberalism.