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Call It 'Murder'

by Susan Rudelitch DiFluri, OTR/L, M.Ed.

EDITOR'S NOTE: What follows was submitted to us as a comment on our news story, Hospital Fined $71,000 For Man's Restraint Death, about Benjamin Wolfe. We felt it deserved an entry in its own right.

I knew a young man. His name was Benjamin. To know Ben was to love Ben. He was a great kid – always willing to help others no matter what the task or labor. He was known to literally give someone the shirt off his back.

Ben was also extremely bright and talented. He practiced music constantly and was a gifted saxophonist. He understood the mathematics of music and could deliver the most ethereal and soulful sax sound. His smile, his creativity and his engaging conversation were aspects of his personality that made one look forward to seeing him, being with him.

We -- his family, his friends, his acquaintances and those he touched through his music -- no longer look forward to Ben's physical presence, for it no longer exists.

I am trying to read through the article in Sunday's edition ofthe Morning Call, "No charges will be filed in teen's death" (also on Ragged Edge Online here), about the young man who lost his life in a facility and a system designed to protect him… and I can't.

I can't because it brings to the forefront of my mind (it is always there, but not always in the forefront), the incident that ended Benjamin's life on October 4, 2004. Ben lost his life at the hands of "mental health workers" in a restraining incident less than 24 hours of his admission to the Gnaden Huetten Behavior Health Unit of Blue Mountain Health System. The hospital was fined by the Pennsylvania Department of Health on many counts, including failing to follow restraint procedures.

Let's call these situations what they are: "Murder", "Manslaughter"! If these same events occurred on a street corner – where ironically and incidentally there are no policies and procedures to be followed, only social mores - someone would be held accountable! Family and friends could have the option of being able to forgive or chastise the face or faces behind the inevitable action that took their loved one's life.

This is the twenty-first century and we still don't get it! We still don't understand "mental illness", "behavioral health". Call it what you will. Perhaps that is the problem – neither of these terms accurately defines the underlying cause of the symptoms of neurologically based disorders. It's easier to minimize someone whose thinking seems skewed, who possibly perceives the stimulus in his or her environment seemingly strangely and whose behaviors seems socially dysfunctional.

We as a "normal" and "well" society created systems to "protect" those that periodically or chronically 'suffer' from these often times neurologically based disorders, as well as protect society from those whose symptoms might in fact be harmful to others. However, the restraining actions to which I refer seem too common and often factually unjustified especially when occurring in a medically and behaviorally based setting.

I am not talking about the 'criminally insane' (and what a horrible term that is). I am talking about the often misunderstood, highly sensitive and sensing, fearful and on the edge of fight or flight individual who, through the less than ideal procedures of the system, is admitted to a facility with the purpose of minimizing these exact symptoms so that he/she can be better able to cope with the everyday realities of life, but who winds up being treated criminally.

Not following procedures for restraints and participating in restraining without training are acts of negligence in and of themselves. When these factors result in another human being's death, they are criminal. Systems need to be held, not only accountable, but responsible. I commend the mother of the teenager in the story I found difficult to read as she plans to fight so that this never happens again.

But I personally am angry at the law. I am angry that yet another facility, another system is protected by a legal system finding no criminal behavior, no criminal intent in these all too common restraint deaths of young and beautiful – though perhaps misunderstood – individuals.

Are we that complacent as a society? Does thinking, "Oh, he was weird kid anyway," justify our negligence? Does it justify our inhumane actions against another…? God, I hope not.

Ben is gone. Maybe you don't know or remember him. His family and friends will never forget him. And someone held him down and didn't respond to his pleas when he said he couldn't breathe… someone killed him. No question. It is the only reality that we can understand. Ben was not a menace to society. He was scared. The last words to his mother on the phone were those seeking reassurance, "Mom, will I be alright?" And she believed he was in a safe place and that he would.

The system not only killed him, it failed her. He had a right to be treated and a right to be protected. He has no human rights now. We had an understanding that a system was in place to do a job. That system and those participants in it not only failed, they were wrong, and their actions were intentional and criminal.

On Friday there was an article in the Lifestyle section of the Lehighton Times News about a 51-year old man, David Borghi, who had years of artwork stored away that he had done during his life. This man had been treated over the years for a psychiatric diagnosis. Today he is being recognized for his talent -- a recent exhibit in Chicago at the 3rd annual Intuit Show of Fold and Outsider Art and a current exhibit at the Marion Harris Gallery in New York City. I mention this man, as I believe that Ben, like David, had talents that would shine later – given time and healing.

We are the losers in this society, we who take away the potentiality of others when allowed to express our own misguided fears and prejudices in jobs protected by systems that had been established to protect those 'others'. We'll never know Ben's potentiality as a musician or as a man, although we are convinced of his brilliance, because a few people in a poorly run system took that away…and another faulty system fails to recognize criminality in its saddest form.

Susan Rudelitch DiFluri has spent 15 years of her 31-year occupational therapy career working in the area of psycho-social dysfunction.

I agree with much of this, although I'd add that even if Ben (or anyone else) didn't have any discernible talent, wasn't a nice person, etc, they still don't deserve to be restrained except in very limited circumstances - life and death circumstances, nothing less (certainly not property damage, risk to others that could be avoided by removing the others, disobeying rules, not respecting staff, etc). Too often rights of disabled people center on the fact that disabled people have some skill rather than the intrinsic value of being human.

it makes me crazy when I read something like this. I am a Certified Mandt system trainer and have been for over 14 years. I work for an agency that provides services to people with all different types of disabilities and thank god we have guide lines and training for staff to protect and keep people safe from what happened to this young man. May god be with him and his family.

As someone who survived the Dr. Willam F. Roberts Hospital School in St. John, New Bunswick:

This isn't new stuff to me, nor is the outcome suprising ... maybe a 1- or 2-digit sum followed by a few zeros may do more to change things than any wait for legislation or reports ever can ... money makes the world go 'round ... they say.

Maybe that`s what it takes to change things for the better for us.

Guidelines and training don't stop this kind of thing.

Guidelines and training did not stop staff at an institution I lived at from trying to kill me, and almost succeeding. They have never been charged in what happened, and probably would not have been charged I'd died.

I did an interview with a woman who'd both lived and worked in institutions. Here's what she said about the "supervised apartments" she worked in:

"Actually if what happened bore any resemblance whatsoever to printed material, both internally and externally, the material we were trained on, the written material we received during training, and the material handed out to parents generally on the outside who were considering placing their children in these kind of situations -- adult children I might add. The literature. If anything that was being written is true, those would've been wonderful places. But none of it was true. I mean I was very often informed that "This is the way it's written, but this is the way it's actually done." This is what's written, this is what's actually done. They would read off policies to us and the same person practically in the next breath would violate them. But we had to know what the official policies were, the official line."

Until power structures are completely changed, "guidelines" and "training" won't do much of anything to protect us. It's easy for staff to think that all you have to do is get a few laws in place, get guidelines, etc, and all the inmates/clients/etc will be safe. That's not how it works in real life for the inmates/clients/etc and most of us are very aware of that fact.

I knew Ben and he was a beautiful spirit who did not deserve what happened to him. To know him was to love him. The stigma of mental illness in our society has not changed all that much over time. I don't know why people can't understand that if it had been diabetes or some other disease that needs to be medically treated though drugs or therapy that kind of illness is understandable but mental illness is different people see it differently which needs to change before something can be done. I also wanted to note that I also know Dave Borghi he too is a wonderful spirit who has faced some difficult times and has perservered.

I only learned of Ben's death this month. I grew up with him. Went to school together. Played together. Performed in band together. He was a really happy-go-lucky guy. It breaks my heart to imagine the personal suffering that he endured, only to end up losing his life at the hands of people who were supposed to help him. My sincerest regards to his family.

hello there.
i am a photographer who is absolutely obsessed with the history of asylums in our county and in Europe. i am redeveloping my website to help those who have been victims of psychiatry or just victims of the way our society handles those with developmental and psychiatric disabilities. for me, seeing images of old historic asylums as they are worn down through natural decay, is a very cathartic healing experience.
i would like to share my own experiences shooting these images and also my experiences with psychologists, psychiatrists and institutions in my own life.
i would love to share this article with my own site visitors, and i would also love to share some of these very relevant and touching comments as well.

i truly believe if we use the internet and things like blogs or personal homepages, we can get the word out, and teach society more about those who have such disabilities in our country.
please feel free to contact me and visit my site and comment:

thank you very much.
Kris d

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