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Vancouver mom concerned about state of mental health care

Columbian - 1/28/2019

Jan. 28--Since November, Cindi Fisher has regularly made the trip from Vancouver to Lakewood, just outside of Tacoma, to visit her son, Siddharta. On a recent visit, Fisher said, she shared a meal with him at Old Country Buffet, took him to a local park and left him with some money.

But after their six hours together, it was time for Siddharta to return to the brick walls and secured windows of Western State Hospital, which as Washington's largest inpatient psychiatric facility has come under scrutiny for health and safety violations.

Fisher, a 68-year-old retired teacher who has been recognized by YWCA Clark County and local NAACP for her activism, said that her son has met his treatment goals and is eligible for release -- but won't be coming home to Clark County.

Fisher said that while her son is no longer required to be in an inpatient psychiatric facility, he still needs extra help with day-to-day living, such as taking insulin for his diabetes. He will be going to a group home in Pierce County.

"He has this record that makes it difficult for people to be willing to accept him, and there is a big shortage of housing," Fisher said. She still worries about her 40-year-old son, who she said has long dreadlocks and a tendency to talk loudly to himself.

At a press event in Burien last month, Gov. Jay Inslee called situations such as Fisher's a "hidden issue" that he hopes to address as part of a sweeping overhaul of the state's mental health system currently being considered by the Legislature. Inslee, who has called for $675 million for his plan, said there is a "huge blockage in the system" of patients at both Western and Eastern state hospitals whose conditions have improved but are unable to return to their communities due to the state's lack of supportive housing.

"And as a result of that, we have people who are languishing in our county and city jails who can't get into our state hospitals," Inslee said.

Goal: Closer to home

There is broad support for the idea of making it easier for people to access mental health treatment in their communities near their families, jobs and churches. There's also evidence it aids their recovery.

Sen. Ann Rivers, a La Center Republican who sits on the Select Committee on Quality Improvement in State Hospitals, said she expects more locally based care institutions to be included in reforms to the state's mental health system.

"I've been to Western State, and I would not want my loved one there," Rivers said.

Clark County has requested $1.75 million from the state's capital budget to fund the Vancouver Housing Authority'sTenny Creek community-based mental health facility, which will provide assisted-living support for people coming out of Western State Hospital. Lawmakers are also considering putting more mental health resources in schools and changing the state's Involuntary Treatment Act.

During her decades of negotiating the state's mental health system, Fisher has objected to her son's treatment and held protests outside of the county courthouse and Western State Hospital. She also helped found Movement Of Mothers and others Standing-up-together, a group of people with loved ones in the mental health system.

Fisher questioned if the new attention from the governor and Legislature will address what she said is the system's tendency to isolate and alienate individuals while over-relying on pharmaceuticals.

"If psychosis were not stigmatized in our society, I think a lot of folks could get through it in their communities," she said.

Early diagnosis

Fisher said that she and her family settled in Vancouver in the early 1980s when she worked as an elementary school teacher and her husband worked as a pharmacist. She said that Siddharta was the oldest of four children. She described him as a bright, sensitive and curious child. She said he wrote poetry, loved playing guitar, won a state chess championship and scored high on the SAT after taking it at age 12.

She said that after experiencing a "very racist incident," his whole world changed. She said that one day in the seventh grade, her son came home from school with a girl's coat. Fisher said her son told her that the coat had been stolen from a girl by other classmates, and he had gotten it back with the intention of returning it to its owner.

But she said that when her son returned the coat, the principal accused him of stealing it. She said her son, who had never been in trouble before, was put in handcuffs and sent to juvenile detention.

Fisher said that afterward, her son became distrustful of authority and started getting in trouble. She said that at age 16, his mental state began to deteriorate. He would become moody, depressed or angry. He began talking to people who weren't there and would pace in his room for hours.

After another brush with the law, Siddharta was ordered to undergo a psychiatric evaluation where he was diagnosed with schizophrenia. She said the medications he was prescribed put him in pain and caused him to engage in self-harming behaviors.

"He begged me to stay up with him all night because he was worried he would jump out of his second story window," Fisher said. "He gave himself a third-degree burn because he wanted to feel something."

She said that one morning in June 1995, he woke up in extreme pain. She recalled him saying he had been poisoned and his insides were burning with acid. Fisher said her son, desperate for help, ran outside their home and began knocking on doors. After no one answered, she said, he broke a window hoping to get help before collapsing in the street. He was arrested. Months later, he began his first stint at Western State Hospital.

'I need to go home'

According to court records, Siddharta was released from Western State Hospital in 1996 with a diagnosis of psychosis. He was again admitted in 1999 for a 72-hour hold and was released after being given medications.

Fisher said that the medications changed her son. She said he would sleep for 16 to 20 hours a day and become depressed over how much time he spent in bed. She said she watched her once-popular son lose all of his friends and sense of belonging. One day, she said he asked her to take him to the airport so he could fly home. Fisher said she took him to the airport where he approached a customer service desk.

"I need to go home," he said.

"I can help you," responded the attendant. "Where is home?"

"That's what I need you to help me with," he said. "I don't know."

Siddharta had bouts with homelessness, and court records indicate he used drugs. He would go on to be committed to Western State Hospital over a dozen times.

Fisher said that the medications given to her son made him confused and caused him to walk into other people's houses, which led to more run-ins with the police.

Fisher criticized how the state's mental health system relies too much on medication. She pointed to the potential of Open Dialogue, a method of treating acute mental illness that was developed in western Lapland in Finland that uses techniques of collaboration and listening that closely involves the patient's family and social network.

Records show that Fisher objected to her son's medications. In 2013, the guardian ad litem appointed for Siddharta filed a restraining order against his mother alleging that she would "threaten and harass any person she feels is causing her son to not have the treatment she demands for him."

Fisher said that dispute was over his medications and also a phone she said should've been installed on the floor her son was housed in at Western State Hospital. For nearly a year, Fisher had no contact with her son until the restraining order was dropped. During that time, Fisher wrote letters, protested outside of the hospital and still found people who would share information.

"Although I couldn't talk to him or touch him or see him, I wasn't out of contact with him," she said.

Back to Western State In November 2017, Siddharta was again sent to Western State Hospital. Fisher said that it all began with a mix-up over a bill at a diner.

Fisher said that at the time her son was in a program to help previously homeless people with serious mental illness and was living in his own apartment. She said he was receiving Social Security benefits deposited on a debit card. Fisher said that there was a delay in depositing benefits on her son's card, and when he tried to use it to pay for a meal at a local diner, it was declined.

According to court records, Siddharta said an expletive to the waitress and left without paying. He was later arrested and charged with theft.

"They put a vulnerable adult back in jail," Fisher said. "That was wrong."

She said that the three days her son spent in custody were destabilizing. When he was released, she said he was intensely sensitive to noise. He became irritated by a jackhammer at a construction site near his apartment, she said, and yelled at them to shut it off. When they didn't, he hit a worker over the head with a bottle.

Court records show that Siddharta was charged with assault after the incident and was required to undergo a forensic evaluation. The evaluation described Siddharta as tall and thin, wearing orange jail scrubs and dreadlocks well below the shoulder. It stated that he spoke in a "loud volume" and appeared as "agitated and disorganized."

The evaluation reviewed previous records describing his previous diagnoses. It drew a familiar conclusion.

"Mr. Fisher did not have the capacity to understand the nature of the proceedings, and he did not have the capacity to assist in his legal defense," the evaluation read.

'You can't live in here too much'

In a phone interview from Western State Hospital, Siddharta said he was looking forward to a visit with his mother, and getting a meal of fried shrimp and mashed potatoes at Old Country Buffet.

When asked what he was looking forward to when getting out of Western State Hospital, he said he was looking forward to "human contact" with friends and family. He said he was looking forward to being able to "live."

"You can't live in here too much," he said.

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