Saturday, November 18, 2017
Human Interest

Florida's craziness connected to Kafkaesque treatment of our mentally ill

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In 1979, when I was in college, the Florida Legislature did something totally ridiculous. (I hope you're not too shocked.)

The state board that licensed psychologists rarely went after quacks who were ripping off patients. So rather than try to reform it, the Legislature just got rid of it.

That meant that suddenly, anyone in Florida who was willing to spend $10 on a county occupational license could claim to be a psychologist. It became a big joke. People bought them for themselves, their kids, their pets. One guy bought one for his chameleon, claiming it was a sex therapist.

So I bought one — an occupational license, not a chameleon sex therapist — and took it back to my college newspaper in Alabama and tacked it up over my desk. I was now officially a Florida psychologist, I announced. The other students were amazed.

"Is that for real?" they asked.

"Absolutely!" I said. "That's how we roll in Florida!"

That is still how we roll in Florida. Whenever people ask me why Florida produces so much weird news, I always point to our huge population, the large number of tourists, so many people from so many different places, the weather and, last but not least, one other key fact:

Florida is routinely ranked as 49th among the states in funding for mental health treatment (which always makes me say, "Thank God for Texas!"). Lawmakers who huff and puff about being tough on crime never seem to see the connection to putting money in the state budget to help the mentally ill.

This year, my Tampa Bay Times colleagues Leonora LaPeter Anton and Anthony Cormier shared a Pulitzer Prize with the Sarasota Herald-Tribune for a yearlong investigation into Florida's mental hospitals. They found that steep budget cuts had turned these places into warehouses of violence. Patients received little treatment. Injuries and deaths were hidden.

You would think Florida would have vowed to be the best, not the almost-worst, after what happened to Kenneth Donaldson half a century earlier.

Donaldson had undergone shock treatments in New York in the 1940s — as a treatment for exhaustion, incidentally — but by 1956, he was living in Pennsylvania and doing better. Before a visit to his parents in Florida, he asked doctors to check him over. They said he was fine.

He headed south and spent a few months fixing things around his folks' house. He planned to go back north to a new job. But shortly after New Year's 1957, two men knocked on the door, told Donaldson was under arrest and took him to the Pinellas County jail.

He spent several days there before someone told him that his father had signed papers to have him committed. A pair of doctors stopped by for a brief chat. Then a judge told him he was being sent to the state mental hospital in Chattahoochee.

"But I'm not sick, Your Honor!" Donaldson protested.

"A few weeks up there — take some of that new medication — what's the name of it? — and you'll be back." Then the judge rang for the jailers to take him away. Rather than "a few weeks up there," Donaldson was gone for nearly 15 years.

Donaldson's account of his sojourn at the Florida State Hospital reads like Kafka. He kept insisting he was not sick. To the Chattahoochee doctors, that was evidence he was mentally ill. He wrote anguished letters to government officials and mailed handwritten motions to various courts, pleading to be let out. The doctors said that was further proof.

"That's your illness, Donaldson," one doctor said. "You are so sick, you won't admit it."

Donaldson spent most of his time locked in a room with about 60 other patients, some of them criminals, some quite violent. Donaldson said later that he suffered from "the fear, always the fear you have in your heart, I suppose, when you go to sleep, that maybe somebody would jump on you during the night."

Years passed, during which he received no treatment. Perhaps that was for the best, though. The principal doctor overseeing his care was an obstetrician.

At last, Donaldson's case caught the attention of the American Civil Liberties Union, which helped him sue the hospital and the doctors.

At trial, the doctors contended he really was getting treatment, something they called "milieu treatment." That meant the time he spent hanging around with other inmates was his therapy.

The medical records were particularly damning. In Donaldson's first year in Chattahoochee, one doctor made a note in his file that his illness appeared to be "in remission." But after that, nothing happened.

The jury found for Donaldson, awarding him $17,000 in damages. They acquitted three doctors but not the two in charge. Those two appealed all the way to the U.S. Supreme Court, which voted 9-0 for Donaldson, finding that the only reason to hold a patient against his will is if he's a danger to himself or others. The ACLU still calls the Donaldson case the most significant court decision on mental health in U.S. history.

For Donaldson, though, the best outcome happened a week before his case went to trial. Foreseeing doom, the doctors suddenly set him free. It was, Donaldson quipped, "a miraculous cure."

Contact Craig Pittman at craig@tampabay.com. Follow @craigtimes.

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