Woman Fights Order To Take DrugsApr 7, 2003 | Anchorage Daily News Faith Myers says she can live with the voices and visions that jar her mind.
She's heard the voice of God telling her when she will die, a state psychiatrist testified recently. She thinks the government was watching her in her Spenard apartment, the psychiatrist, Robert Hanowell, said. Certain telephone numbers scramble her brain and confuse her.
State psychiatrists have gone to court to force her to take powerful, anti-psychotic drugs to treat her delusions and hallucinations.
But Myers argues that such a tremendous decision should be hers. The medicine changes the way she thinks, dulls her senses, makes her tired. She prefers life without the drugs, bizarre and disturbing as it may be.
Myers, 51 and a former Anchorage child care worker, is diagnosed as suffering from paranoid schizophrenia. She's been at Alaska Psychiatric Institute since Feb. 21, when her family obtained a court order to have her evaluated. A judge has since ordered her committed, ruling that she was a danger to herself and others.
Mainstream psychiatrists rely on anti-psychotic drugs as a quick way to bring people back to reality. Myers is among a vocal minority of patients and psychiatrists who reject the standard treatment as ineffective and harmful.
For most of the past two decades, Myers has taken prescribed anti-psychotic drugs. Their tranquilizing effects blur her memories.
"It's almost as if my whole family life has been taken from me," Myers testified at a March 5 court hearing. And she thinks one of the drugs caused voices.
At her request, the hearing was open to the public, allowing a rare glimpse into usually private mental health court proceedings. API's director and medical director have not allowed her to be interviewed at the hospital.
She can explain much of what sounds odd and scary, said her attorney, Jim Gottstein. For instance, her psychiatrist testified that she thought someone close to her was taken over by an impostor. But that person may have early signs of Alzheimer's disease, so in reality has changed, Gottstein said.
On the witness stand, Myers came across as matter-of-fact, calm and candid. She wore API-issue turquoise blue sweats, though the hospital lets patients dress in their own clothes.
For much of her adult life, Myers has struggled with mental or emotional problems, she testified. She's been at API before and other treatment centers too. Doctors prescribed different drugs at various times.
In 1998, doctors added a second anti-psychotic drug to her regimen. But it didn't stop her delusions. She mistook red traffic lights for green ones and the other way around.
She took herself off one of the drugs, but remained on the other, an anti-psychotic called risperidone. She began hearing voices. One claimed to be the voice of God, commanding her to drive all over the city.
"It was as if the risperidone punched a big hole into the brain that let all these spirits or voices into my brain," she testified.
Her fight to get off the medicine was exhausting. She could no longer work in child care. She lived in her vehicle like a street person and at other times with friends.
In December 2000, she ended up at API and during a six-week stay was prescribed a newer anti-psychotic drug, Zyprexa, which is supposed to have fewer side effects.
She testified that she married someone she met in treatment, but the medicine masked how controlling and rigid he was.
"Her concern is that it makes her paranoia less," Hanowell, her treating psychiatrist at API during her current stay, testified. It's "kind of paradoxical."
A year ago, she weaned herself off everything. She said she does well when she's away from people -- "alone and quiet in nature." She doesn't believe she is mentally ill and thinks she can help herself with good nutrition, Hanowell testified.
But her grown children worry that she's not safe without her medicine. Things worsened this year, her daughter, Rachael Humphreys, testified.
When she visited her mother in February at her Spenard apartment, there was clothing in the fridge but no food, Humphreys said. She took her mother grocery shopping.
A couple of days later when she visited again, her mother had hung a cabbage outside for moose and set food around inside and out for wild animals, Humphreys said. Money was in a bag outside, along with the mail.
Humphreys said she told her mother it wasn't safe to feed wild animals. Myers responded that animals were better than people. She then became angry and said children were monsters, Humphreys testified. Her mother said Humphreys' 18-month-old baby knew what she was talking about, Humphreys testified.
The apartment manager's wife told Humphreys that her mother would have to go. She was scaring the neighbors, Humphreys said.
Myers' family got a court order to have her evaluated at API.
It's not unusual in Alaska for people with mental illness to battle the system. But it is very rare for them to do so in an open courtroom at a full-blown hearing, as Myers did.
The hearings usually take just 10 to 30 minutes behind closed doors at API every Tuesday and Friday. Last fiscal year, there were 166 such hearings at API that resulted in people being committed for 30 days, as Myers was. Usually, just one or two a year go the other way, said Randall Burns, who just stepped down as API director.
Myers' case took four and a half hours before a Superior Court judge. Her attorney, Gottstein, is an advocate for the mentally ill. He has had his own struggles and calls himself a survivor of the system. He serves on the Alaska Mental Health Board, a state agency, and worked with Myers on the Alaska Mental Health Consumer Web, a support organization.
The medications that doctors want Myers to take are ruining thousands of lives, and she shouldn't be forced into taking them, Gottstein said.
But the science of modern psychiatry isn't on trial, argued Jeffrey Killip, an assistant attorney general representing API. Under Alaska law, the issue is simply whether Myers has the mental capacity to provide "informed consent" regarding the medicine.
"It is troubling that the statutory scheme apparently does not provide a mechanism for presenting scientific evidence challenging the proposed treatment plan," Anchorage Superior Court Judge Morgan Christen wrote in a March 21 order.
Like Myers, most patients don't come to API voluntarily. Once inside, however, many patients agree to stay without a commitment hearing, Burns said.
Nancy Groszek, a public defender, has represented people fighting to get out of API for most of the past 20 years.
These days, the state psychiatrists are "savvy about civil rights," she said, and are not eager to lock up people who don't need to be there. She often tries to work out an agreement. For instance, a patient could agree to take prescribed medicine, and the hospital could agree to let the person out in three days, provided the person continues with outpatient treatment.
"Hearing voices is very uncomfortable," Groszek said. "Some of the voices are really evil and really mean and real destructive."
But the side effects of medicines can be horrible too, she said.
Some earlier medicines, for instance, caused Parkinson's-like tremors. Indeed, even the newer versions of anti-psychotic drugs come with bad side effects such as weight gain, are not a cure and can make people worse, according to a prominent San Diego psychiatrist who testified for Myers.
"They just dumb you down and you don't feel like yourself," Dr. Loren Mosher said in an interview. "You are detached from the world." He believes in talk therapy and intensive, structured therapeutic living, especially for people suffering their first psychotic breakdown.
He was the first chief of schizophrenia studies, from 1968 to 1980, at the National Institute of Mental Health. He resigned from the American Psychiatric Association in 1998 to protest how psychiatry, in his words, "has been almost completely bought out by the drug companies."
Mosher testified that he hoped that Myers "gets out and without drugs."
But Nick Kletti, the outgoing medical director of API, said that drugs provide the quickest relief to patients and that most willingly take them.
Myers needed to be committed because her illness made her a danger to herself and others, Christen ruled March 5. The question of medication was more difficult.
"In this case, I find that there is indeed real and credible evidence supporting the conclusion that a genuine difference of opinion exists between credible psychiatric experts regarding these medications," Christen wrote in a March 14 order.
It wasn't clear that Myers was thinking rationally enough to decide for herself, the judge determined. The state psychiatrists can force the medicine, she ruled.
The medication decision is on hold for now while Gottstein pursues an appeal to the Alaska Supreme Court.