Open letter to social worker supervisor from New York-Presbyterian Hospital, West Chester

Good morning Alexis,

Following up on this item…

I was referring to numbers 16, 17 and 19 in the patient bill of rights. 

Will you please send me my itemized bill as well as the standard list of charges?

I also need to know how to obtain a copy of my entire medical record. 

That should include my written complaint asking for a single delusion of mine to be documented. 

I never received a written response, so this will be at the top of my complaint to NY state’s department of health. 

I don’t know what this patent violation of my rights entitles me to, but I look forward to learning more after speaking with the authorities. 

I will begin the process to file a civil lawsuit against the two psychiatrists who “treated” me against my will and your employer in the weeks to come. 

Buenas Dias from Todos Santos. 

The best is ahead. 

Regards,
Francesco

Those who are capable of tyranny are capable of perjury to sustain it.

“Those who are capable of tyranny are capable of perjury to sustain it.” 

― Lysander Spooner

Perjury was committed today, as the tyrannical acts against me continue.

A life threatening substance, or two, will be forced into me tomorrow, in the name of medicine.

This place… NewYork-Presbyterian Hospital… and places like it… the psychiatrists who work here are on the deck of the Titanic.

Chances are… I will survive this tyrannical chemical assault on my body.

This nasty business surely will not survive the next quarter century, in its current form.

Mark my words.

#thenellieblyproject

cc: Michael O’Neil Joseph Guariglia The Washington Post WIRED

Addressing Secretary David Shulkin and his top 650 reports in 2017

Prior to working with Carl Bialik on #thenellieblyproject, the honor and privilege high watermark of my career was addressing Secretary David Shulkin and his top 650 reports at the 2017 U.S. Department of Veterans Affairs Senior Leadership Meeting.

The link below will take you to a 10 minute video of my remarks.

http://Iamyourdreamcometrue.com

#humbled#lucky#grateful

Open Letter to The Washington Post’s Robert Costa

Dear Mr. Costa:

IT’S relatively EASY TO MAKE A BUCK from hospitals who employ “white coats” (psychiatrists) who involuntarily force drugs that can kill or disable hapless people tagged with mental disorders from a nosology deemed invalid 7 years ago by the former director of the NIMH, Thomas Insel.

IT’S HARDER TO MAKE A DIFFERENCE for the unfortunates tyrannically imprisoned, in the name of medicine, ostensibly because they pose a safety risk to themselves or others.

Please don’t believe me, rather compare the patient experiences and financial fortunes amassed by me and my Zahm Hall section mate from the class of ’93, Michael O’Neil, Founder and CEO of the GetWellNetwork.  

The differences you will find are dramatic and important.

Your colleague, Mr. Tom Brokaw, closed his commencement address with the capitalized lines above back in 1993, and this scoop of a story clearly demonstrates Mr. Brokaw was and remains correct.

It’s time to dismantle the tyranny of “coercion” in mental healthcare in this country.

Thank you for your time and consideration. 

Sincerely,

Francesco Bellafante

Nellie Bly and I

By Anonymous

One hundred and thirty-one years before I spent 31 days locked up against my will, Nellie Bly spent 12 days locked up by choice. Our circumstances were different. Our locations were barely a mile apart. Our experiences had a lot in common.

Before I was locked up, I unwittingly had been acting differently than I ever had before, worrying the people around me with poor decisions and in some cases causing them emotional pain. Before Bly’s, she had wittingly been acting differently than she usually did, deliberately worrying strangers so that they would lock her up.

Bly, at age 23, invented and improvised the role of her lifetime: a woman confused and confusing enough for New York City officials to lock her in an asylum, during a time when the concept of madness was one of many tools men used to exert power over women. Bly was paid to be a journalist; she enabled her best journalism by being an actor. Her goal was to investigate asylum conditions from the inside. She succeeded, and after two days at Bellevue Hospital and 10 days in the Women’s Lunatic Asylum on Blackwell’s Island, the New York World came to free its undercover investigative correspondent. Two days later, she began publishing what she’d learned.

The impetus for Bly’s investigation was a series of reports of poor treatment by Blackwell’s staff members, including two indicted for killing a “lunatic.” Before getting the assignment, Bly had been trying and failing to land a spot at a New York newspaper while her funds dwindled, according to Brooke Kroeger’s biography of Bly. Being locked up for perceived insanity offered an opportunity to exercise what would become Bly’s most successful brand of reporting: an undercover exposé of a little-known phenomenon that would horrify most people if they knew about it. Bly’s report showed how the state had granted doctors the power to lock up and abuse people who had been convicted of no crime, that doctors lacked the ability to diagnose and treat locked-in people effectively, and how the people that the system branded as lunatics had no rights or credibility by virtue of being branded.

Her investigation sparked outrage and brought more funding to asylums. In 1922, after Bly’s death, her friend and former editor Arthur Brisbane called her “THE BEST REPORTER IN AMERICA” and wrote that her exposure of Blackwell’s “improved the conditions of thousands of unfortunate inmates all over the country.”

I knew none of this until two years ago. In my 15 years working as a journalist, I had never heard of Bly, a pioneer in my field. I’d also never read any of the books that teach childrento emulate her courage and achievements. I’d never thought much about the thousands of psychiatric inmates all over the country, or of how their conditions had changed since Bly published the articles that were later collected in her book “Ten Days in A Mad-House.” And I had never considered that I could end up as one of those inmates myself.

Then, between March 12 and April 17, 2018, at age 38, I encountered the modern-day version of the system Bly exposed. First, I was locked up for 31 days: in two California psychiatric facilities—Eisenhower Urgent Care, Rancho Mirageand Pacific Grove Hospital—for three days; then, five days after my release, in a New York City institution—NewYork-Presbyterian/Weill Cornell Medical Center—for 28 days.

I entered Weill-Cornell with many privileges: moderate wealth; excellent health insurance; a wise and caring primary-care doctor; loving family and friends—including doctors, lawyers, and journalists; my previous career as a journalist, and the public credibility it allowed me to build; my prior experience as a hospital patient, for treatment of an abdominal abscess; not experiencing symptoms that are most likely to heighten fear in others, such as hallucinations; being a white young man; and living in a city with many highly regarded institutions, led by Weill-Cornell.

I also entered Weill-Cornell wanting to understand my behavior and to restore my health. I knew I was acting unlike my usual self: I was overconfident and taking risks in my personal, professional, and financial lives. I wasn’t sleeping or eating enough. I also was coherent, peaceful, and had caused no physical harm to myself or others.

Quickly I concluded I wanted to leave Weill-Cornell and seek better treatment elsewhere. Quickly I learned that my privileges wouldn’t suffice, and that people without similar privileges had even less chance of freedom.

Three times I tried to escape my bonds: once by walking out, and twice by going to court. Each time I failed. In my first eight days of confinement I tried to exercise my right to decline to take psychiatric drugs. Four times doctors forced drugs into my body without my consent, once by using physical force.  My symptoms had dissipated before I went to court on my ninth day; my resistance dissipated after I lost in court. “Unfortunately, the patient is very intelligent, very well spoken, and maintains a very good composure in court,” the judge curiously described my lack of symptoms, according to the transcript, before authorizing unlimited further nonconsensual drugging of me, with up to eight different powerful sedative and psychoactive chemicals. No matter that at no time had I met the standard for locking up a New York resident who hasn’t committed a crime: posing “a substantial threat of harm to self or others.”

The United Nationshas called for people in mental-health facilities to be treated with respect, humanity, the best available healing, and all other basic rights, free from abuse and discrimination. That goes for everybody, including anyone for whom being locked in could prevent harm to themselves or others, anyone who chooses to be locked in for their own safety, and anyone who is healed while in those facilities. Bly’s treatment conformed to none of the principles adopted more than a century later by the U.N. General Assembly. Neither did mine, 27 years after they were adopted. Neither have dozens of unnamed respondents to threerecentsurveyswith a self-selected set of respondents and one with a representative set. Many inmate have had fewer privileges than me, and many suffered more.

After I got out, I studied the system that had just locked me up, its victims, and its critics. I learned the names of hundreds of other people who had been affected by the system, opposed it, or offered alternatives: people from hundreds of years ago and from today who had their own close encounters with the treatment of people diagnosed as mentally ill, and who chose to tell others what they’d seen. Some won campaigns for improvement; most watched the system resist and persist. They include inmates Clifford Whittingham Beers, who turned his mistreatment into a movement; and Adrian Schoolcraft, locked in a hospital by fellow police officers for blowing the whistle on their abuse of power. They include journalists Charles Dickens, sickened by what he saw at the asylum that would later house Bly; and Rosalind Adams, who documented how people seeking help get locked in so public companies can turn a profit. And they include people who proposed promising alternatives to locking people up, such as Loren Mosher, whose results were so good his project was shut down and his title stripped; and Pablo Sadler, whose New York City program offers an alternative to ER visits like mine.

And I read about Nellie Bly.

I read what Bly wrote, and read what others wrote about her. And I was struck by how alike her and her fellow inmates’ experiences at twofearedpublic New York City institutions in 1887 were to mine at a nearby renownedprivate NYC institution in 2018. I was struck by how little evidently had changed despite her journalistic triumph.

Any two people swept up in the system, like any two people anywhere, are vastly different, including in their health and in their ability to respond. That’s true for me when the other person is an 1880s undercover journalist, and when it’s the person in the bed next to mine in the asylum. What unites us is how we are seen and treated by the system, and our outrage at the treatment and lack of oversight, justice, and reform.

Bly took notes while she was locked up. So did I. To tell my story today, I read what I wrote at the time, including in a hospital notebook, online, and in emails. I also read my medical records and court documents, listened to consensual audio recordings I made at the time, filed a public records request for reports I made at the time to a government patient hotline, and ran this account by loved ones who visited me while I was locked up.

Below is Bly’s story, as told in “Ten Days in A Mad-House,” and mine. Excerpts from her book are italicized.

“I myself cried for water until my mouth was so parched and dry that I could not speak.”—Blackwell’s inmate Bridget McGuinness

My three days of being locked up in California started with an ambulance ride to Eisenhower. On the ride, I got thirsty and asked for water. No one gave me water: not in the ambulance, not once I’d arrived at Eisenhower. No one made eye contact with me when I asked. When the doctor appeared and authorized water, I got some, along with a nonconsensual drugging delivered by the doctor with a forceful jabbing that left me bleeding.

Later I protested my experience at Eisenhower. In response I received a letter stating that “Your medical records were reviewed by the Medical Director of the Emergency Department and the care and treatment provided was appropriate for your presentation.” I wasn’t interviewed or contacted as part of the review.

My three days of captivity ended with my having spent a total of five minutes with a psychiatrist. Pacific Grove discharged me without a prescription or an appointment with a doctor.

In psychiatry, disease has no biological testsand ever-shifting definitions, meaning two doctors often disagree about the same case, at a frequency that would be considered poorin other medical specialties.

Then he wrote my fate in the book before him. I said, “I am not sick and I do not want to stay here. No one has a right to shut me up in this manner.” He took no notice of my remarks, and having completed his writings, as well as his talk with the nurse for the moment, he said that would do…—With a Blackwell’s doctor

In my book of fates, Weill-Cornell doctors justified locking me in by citing my opposition to being locked in and nonconsensually drugged: I was “resisting being changed into patient clothes” and exhibiting “poor judgment and insight” by “refusing [Emergency Department] treatment.”

Today doctors call questioning a psychiatric diagnosis anosognosia, and treat it as a symptom of many diagnosed disorders. That sort of meta name-calling is a good way to win any argumentand preserve an unblemished record of diagnostic accuracy.

I recorded audio in the Weill-Cornell emergency room until my phone was taken from me and turned off. I can hear

  • the door shut behind me;
  • my repeated requests for a lawyer go ignored;
  • being told I need to take off all my clothes and get into paper scrubs;
  • refusing to give up my phone;
  • asking to leave and being told I can’t;
  • asking what crime I’ve committed;
  • the sound of being forcibly separated from my phone.

After this, I began to have a smaller regard for the ability of doctors than I ever had before, and a greater one for myself. I felt sure now that no doctor could tell whether people were insane or not, so long as the case was not violent.—At Bellevue

I made several requests of the doctors assigned to me: persuade me of their diagnosis; let me record audio of our sessions; let me see different doctors instead.

Today my requests strike me as reasonable ones I’d make again. To my doctors they were signs of my paranoia and litigiousness, each of which they referred to dozens of times in my medical record as symptoms of disease.

Among the ways doctors referred in my medical records to my behaviors and beliefs as disease markers and evidence I needed to be locked in:

  • “precise attempts to out-logic and out-argue”;
  • “trying to argue against both, skillfully”;
  • “continues to have logical, intellectualized defenses”;
  • being “argumentative”;
  • “Hypervigilance”;
  • considering myself locked up instead of an “inpatient admission”;
  • using wordplay; writing online criticism of the institution and doctors.

My disagreements with the doctor put in charge of my case contributed to the contentious nature of our relationship. Our daily consultations were short, my remarks brief. One day I remember deciding to try a friendlier tone. Later that day, her assistant told me the doctor was now forcing me to take an additional brain-altering drug because the change in my manner that day had worried her.

My discharge from a place where I had no choice in doctors restored my freedom to choose a doctor. And I shopped around. I saw nine different doctors and therapists within two months. Each one had to list a diagnostic codefor my insurance claims. Nine practitioners used eight different diagnostic codes between them. One thing they can all agree on: I’ve had no symptoms of illness. That’s helped spare me further incarceration.

Psychiatric diagnosis ishard.

I always made a point of telling the doctors I was sane and asking to be released, but the more I endeavored to assure them of my sanity the more they doubted it.—At Blackwell’s

“Insight” is what doctors today call inmates’ acceptance of doctors’ diagnosis and cooperation with doctors’ proposed course of action.

My insight was that I didn’t want to be locked up, I didn’t think it was good for my health, and I wanted my rights restored.

I tried to register my objections in any way I thought might help. I started a hunger strike. I shared my concerns with dozens of visitors and staff members. I contacted other journalists and the hospital’s public-relations department. I wrote about my experience online and urged other inmates to do so. I submitted a column to the New York Daily News. It began, “Thousands of New Yorkers are trapped against their will, victims of the most insidious threat to civil rights today. I know because I am one of them.”

To doctors, these were all clear signs that I did not have insight, and that their diagnosis was  confirmed.

They told me not eating wasn’t an act of civil disobedience but a symptom of illness.

They told me my decision to go to court to seek release demonstrated a lack of insight and would keep me locked up longer.

They told me my attempts to publicize how I’d been treated were distracting from my care.

They told me I couldn’t leave until holding a meeting with them and my loved ones, in which I would be forced to give up my right to decide with whom to share my medical information. I would have to demonstrate obedience to the doctors before others to be considered for discharge.

I had a new insight: I would have to give up and obey to leave. So I did. And after I did, doctors agreed: I had insight.

“Do you ever hear voices at night?” he asked. “Yes, there is so much talking I cannot sleep.” “I thought so,” he said to himself. Then turning to me, he asked: “What do these voices say?”—With a Bellevue doctor

Bly meant the voices of staff keeping her up.

Combine confirmation bias with the power imbalance between doctor and inmate, and the theft of credibility caused by being branded mentally ill, and you get Bly’s experience of a doctor hearing something she didn’t say.

You also get these experiences of mine:

I’ve covered over a dozen tennis Grand Slam tournaments as a professional journalist. During those two-week periods I have sometimes been happy, active, and underslept—just like many of my colleagues. I mentioned this to doctors, who recorded my comment in my medical record as if I had corroborated their suspicion that I had a history of mental illness.

I was invited to an awards ceremony in Oslo, scheduled shortly after I’d been locked up. I had attended the same event the previous year, when it had been held at the Norwegian consulate in New York. I spent a few minutes submitting a free, no-commitment electronic RSVP, in case I decided to go. A concerned person believed a falsehood, that I had bought an airline ticket to Oslo, and told doctors. I tried explaining the error. My nonexistent ticket to Oslo made it into the document submitted by my doctor to the judge who’d hear my case for discharge—and along the way, Norway had become Finland.

I told my doctors I thought their thinking and mistakes exhibited confirmation bias. They included my comment in their notes as a sign of my active illness.

What, excepting torture, would produce insanity quicker than this treatment?—At Blackwell’s

My cycle went like this: Doctors denied my requests such as for recording, changing doctors, wearing my own clothes, or using computers. That turned me into their untrusting antagonist. Doctors then equated my antagonistic stance with illness, and dug more firmly into their own antagonistic stance.

As I testified at my second court hearing, according to the transcript, “Disagreement is not a mode that seems like one the treatment team is used to undergoing.”

“I will be honest with you,” the judge concluded. “I find your position and your testimony and your demeanor to be very compelling, but I find this doctor’s testimony to be credible.” He allowed the doctors to keep me locked up for up to 14 more days. “For right now I think you are almost there, but not quite yet,” he said.

He sat silent, unable to contradict my assertion. “Why don’t you have it changed?” I asked. “What can I do?” he replied. “I offer suggestions until my brain is tired, but what good does it do? What would you do?” he asked, turning to me, the proclaimed insane girl.—With Dr. Ingram at Blackwell’s

My doctor’s assistant repeatedly professed powerlessness when I asked why he couldn’t change something he claimed to agree needed change: about my treatment, or about the institution that paid him. He then repeatedly asked me how I would change it. These conversations were not recorded in his notes in my medical record.

Compare this with a criminal, who is given every chance to prove his innocence.—At Blackwell’s

People in penal prisons often experience inhumane conditions and abuse.

Psych wards are like prisons, and their inmates sometimes experience similar abuse, for similar reasons. 

Things some penal prisoners have that we didn’t:

  • outdoor time;
  • the possibility of conjugal visits;
  • freedom from having chemicals forced into you;
  • a release date.

One night they came in and tried to make me take a dose of some mixture out of a glass “to make me sleep,” they said. I told them I would do nothing of the sort and they left me, I hoped, for the night. My hopes were vain, for in a few minutes they returned with a doctor, the same that received us on our arrival. He insisted that I take it, but I was determined not to lose my wits even for a few hours. When he saw that I was not to be coaxed he grew rather rough, and said he had wasted too much time with me already. That if I did not take it he would put it into my arm with a needle. It occurred to me that if he put it into my arm I could not get rid of it, but if I swallowed it there was one hope, so I said I would take it. I smelt it and it smelt like laudanum, and it was a horrible dose. No sooner had they left the room and locked me in than I tried to see how far down my throat my finger would go, and the chloral was allowed to try its effect elsewhere.—With Blackwell’s night nurses

Doctors’ language made violence sound like kindness. When staff forced me to choose either nonconsensual drugging by mouth or by needle, it was described in my medical record as “offering” or “giving” “treatment,” or of my “requiring” it. “No drugs” was not an option.

According to the transcript of my first court hearing, my doctor described an incident in which I was told by a doctor surrounded by a half dozen other staffers, including security guards, to swallow drugs or I’d be forcibly injected, like this: I had taken a drug “in the presence of security.”

Superintendent Dent went through the sitting-room, giving an occasional “How do you do?” “How are you to-day?” here and there among the patients. His voice was as cold as the hall, and the patients made no movement to tell him of their sufferings. I asked some of them to tell how they were suffering from the cold and insufficiency of clothing, but they replied that the nurse would beat them if they told.—At Blackwell’s

Each week doctors and other staff members hosted what they called a community meeting. Attended by the chief doctor, his colleagues, and any inmate who showed up, it was billed as a forum to exchange candid views about the state of care.

Seeing my first week’s community meeting as an opportunity to create dozens of witnesses to illegal behavior, I objected to nonconsensual drugging of inmates, citing my own experience. The chief reacted by smilingly soliciting testimonials from other inmates about how my uncooperative behavior on the ward had upset them.

After the meeting, I politely sought to continue the conversation with the chief. He was out in the open, surrounded by colleagues and other inmates. He responded by backing away and telling me he found my demeanor threatening.

“Shut up, or you’ll get it worse.”—Miss Grupe, a Blackwell’s nurse, to inmate Tillie Mayard

“Other people are not shut up for crazy when they get angry. I suppose the only thing to do is to keep quiet and so avoid the beatings which I see others get.”—Blackwell’s inmate Margaret

Doctors can take away people’s freedoms: to leave, to refuse chemicals, or to do anything else. They expect obedience in return. Obey and you get comparatively good treatment: soda, snacks, your meds where and when you want them. Obey and you don’t get assaulted and nonconsensually drugged with violence. Obey and you get out.

Every half-hour or hour they would walk heavily down the halls, their boot-heels resounding like the march of a private of dragoons, and take a look at every patient.—At Bellevue

Every 15 minutes staff checked on each inmate. Some staff members were quiet; many were not. Every waking minute in the low tide between checks I spent seeking slumber while fearing it wouldn’t come before the inevitable high tide of the next check.

The people paid to heal us walked with a heavy gait, talked loudly, and locked, unlocked, and slammed doors when we were supposed to be sleeping. Then my difficulty sleeping was cited as a symptom of madness, and a justification for nonconsensual administration of tranquilizing drugs.

I could not sleep, so I lay in bed picturing to myself the horrors in case a fire should break out in the asylum. Every door is locked separately and the windows are heavily barred, so that escape is impossible.—At Blackwell’s

Unless there is a change there will someday be a tale of horror never equaled.—At Blackwell’s

The two fire-escape doors in our 11th-floor locked area, staffed many nights by no more than three people awake at any time, were locked as well, despite the well-known history of danger from firesto people who are locked in.

People in the world can never imagine the length of days to those in asylums.—At Blackwell’s

To doctors and nurses, the days must seem nonstop, with every moment spent either with inmates, or documenting moments with inmates.

There were far more inmates than staff members, so for us there was little to fill the 23 hours between our time with doctors besides worrying about whether they’d respond positively to what we planned to ask. Meals, optional group therapy, computers, books, newspapers, and television—its max-volume setting made part of your day even if you didn’t want it to be—were the lights and lowlights.

Exacerbating the elongation of days: not knowing how many were left in your sentence.

Poor patients! How eager they were for a breath of air; how eager for a slight release from their prison.—At Blackwell’s

I looked at the pretty lawns, which I had once thought was such a comfort to the poor creatures confined on the Island, and laughed at my own notions. What enjoyment is it to them? They are not allowed on the grass—it is only to look at.—At Blackwell’s

The UN saysall prisoners must have access to the outdoors. Some psychiatric inmates get to go outside, as Bly did.

We at Weill-Cornell got no outdoor time—unless we went to court.

In four weeks, I got roughly four minutes of fresh air, from the eight brief trips to and from the ambulance for my two court dates:

  • from Weill-Cornell to the ambulance parked outside;
  • from the ambulance to Wards Island’s Manhattan Psychiatric Center, home of the makeshift court;
  • back from court to the ambulance;
  • back from the ambulance to Weill-Cornell.

Once, and then again a week later.

“I want my book and pencil,” I said, quite truthfully. “It helps me remember things.”—At Blackwell’s

Though I wasn’t employed by a newspaper or on assignment, I also reported on my own case, filling a notebook during meetings with doctors and other crucial moments. My notetaking habit was noted in my medical records as another symptom of illness.

I wish I’d taken more notes. I wish I’d been permitted to record audio of sessions so I had more evidence that would be less easily disputed.

What I would go back to tell myself then, and would tell others now: Document everything. And ask for a lawyer.

In giving this story, I expect to be contradicted by many who are exposed. I merely tell in common words, without exaggeration, of my life in a mad-house.

The word of many stood against mine: They said I was not competent to be free, to make my own medical decisions, to use the Internet, to use the phone or bathroom unmonitored.

The word of many also corroborates mine. My medical records largely line up with what I write here, once I unskew the falsehoods and confirmation bias. There’s little reason for the system to fear repercussions; it has withstood so many challenges before.

The insane asylum on Blackwell’s Island is a human rat-trap. It is easy to get in, but once there it is impossible to get out.

A place operating under the logic that if you’re there, you need to be there, can keep you for a long time.

They pounced upon her and slapped her face and knocked her head in a lively fashion. This made the poor creature cry the more, and so they choked her. Yes, actually choked her. Then they dragged her out to the closet, and I heard her terrified cries hush into smothered ones. After several hours’ absence she returned to the sitting-room, and I plainly saw the marks of their fingers on her throat for the entire day.—Blackwell’s nurses with inmate Urena Little-Page

…she caught the woman by her gray hair and dragged her shrieking and pleading from the room. She was also taken to the closet, and her cries grew lower and lower, and then ceased. The nurses returned to the room and Miss Grady remarked that she had “settled the old fool for awhile.” I told some of the physicians of the occurrence, but they did not pay any attention to it.—Blackwell’s nurses with an inmate known as both Mrs. Grady and Mrs. O’Keefe

I didn’t experience or see anything this abusive. Iwaslucky.

I did experience being dragged, handled roughly, pinned to the ground under the weight of three people, deprived of air, drugged nonconsensually with an injection in my butt, and kept in isolation past the typical duration by a man who yelled in response to my request for an explanation or release.

On the day of my assault, I

  • bore witness to a roommate who was about to be nonconsensually drugged for what my doctor later called “physical escalation” and what I saw as expressing frustration at his being locked up by throwing books at the floor, near no other person and putting no one in danger;
  • told the staff member who claimed I needed to leave during the nonconsensually drugging to protect my roommate’s privacy that I thought I was being asked to leave to protect the staff’s privacy and jobs;
  • told my roommate he had rights and that we should stick together;
  • objected to our forced separation into separate rooms;
  • called my lawyer;
  • after I had been assaulted, told the man who had been most violent that he ought to release me from seclusion because he was only digging himself a deeper hole;
  • stayed calm and nonviolent throughout.

The next day, at my first court hearing seeking release, my doctors cited the assault as evidence that I had become even sicker than before and was in even more dire need of further hospitalization; why else would I have needed such rough handling? According to the transcript, my doctor described me as having been “charging away from staff.” Consider the phrase “charge away,” and what kinds of actions people can take that might provoke someone to charge away from them.

Among the dozens of phone numbers I called to report the assault was the New York State Justice Centerhotline, which I’d been told existed to protect inmates. My suspicion is that report—one of 14 of mine recorded by the Justice Center and turned over to me later in response to my public-records request—got back to doctors, who told me they were investigating. The team of investigators spent a total of a few minutes getting my account. The only result of the investigation I saw was that my chief assaulter and captor was temporarily transferred to another ward, until staffing issues brought him back into my proximity. Weill-Cornell claimed to have conducted another investigation after I complained following my discharge. The institution cleared itself without interviewing me: “Please note the review shows the standard of care was met, a Weill-Cornell representative wrote to me. About my assault, she wrote, “The review explained this was an appropriate and necessary measure at the time.”

I reported Weill-Cornell to my insurer, which responded, “As a result of your inquiry, we will be conducting an investigation within our established peer review process, which, by law, must remain confidential.” I wasn’t contacted further and never learned the result of the investigation.

Here’s the end of the Justice Center operator’s notes about of my call just after the incident, with names removed by me:

“He then went to the phone to call his lawyer [name] at about 5:30PM and while on the phone, about 10 staff members surrounded him. Nurse, [name] Unknown, Staff [name] and [name]

Unknown and Dr. [name] were present. They all forced him to get off the phone and hung up the phone on him. He was told he needed to go somewhere to take medications. He told them that if they had to give him medications, they had to do it there, but was told no. He then went limp on the ground and he was forcibly picked up and brought to the seclusion room. He was set down on his stomach in the seclusion room and he was still not resisting. Staff [name]

and two other unknown security officers were on top of him. One staff was on chest, while the other two were on his legs and arms. It was difficult for him to breath with the staff on his chest. He was told he needed to take the drugs and he said he would take them orally. He was told no and his pants were pulled down and he was injected in the buttocks. The staff continued to hold him down and a few minutes later they all got up and left and locked the door. Staff [name] was stationed outside the door and told him he would let him out in 5 minutes if he was calm. He ended up being in the room for 40 minutes, with [name] outside the door. He was let out and was given his notebook back, a little torn up.”

Hundreds of days before I’d heard of Nellie Bly, and just after I’d been surrounded, dragged by six people, restrained by three, made short of breath by one person’s weight, nonconsensually injected with sedatives, and locked in isolation, I thought to myself, When people learn what just happened to me, it won’t happen to anyone ever again.

That was the craziest thought I’ve ever had.

Delaware’s involuntary commitment laws violate a patient’s right to due process

November 12th 2019

Dear Governor Carney & Delaware General Assembly Members:

I am writing to follow up on my September 30th message about working together to change the involuntary commitment process in Delaware.  

Last month marked four years since Caroline Ekong lost her life, and Christopher Frick lost his freedom.  The tragic outcome of this doctor/patient relationship highlights an obvious discrepancy in how Delaware’s legal framework protects the rights of people subject to severe deprivations of liberty.

Christopher Frick and Dr. Caroline Ekong

It doesn’t take a legal scholar to recognize that Frick had greater due process protection after he confessed to killing Ekong compared to when she decided to deprive him of his freedom for medical reasons. 

The people of Delaware need a civil commitment process that does a better job of protecting patients’ civil rights. Changing Delaware’s civil commitment procedure in a way that safeguards a patient’s right to due process will serve to prevent future tragedies like this one.

Alexander Tsesis, Assistant Professor at Loyola University, School of Law in Chicago is the legal scholar who wrote “Due Process in Civil Commitments,” which was published in the Washington and Lee University Law Review in 2011.

Professor Tsesis’s writing cogently explains why and how we should change the process used in Delaware to deprive people deemed to be suffering from a mental health condition of their liberty. 

Tsesis argues, that: 

…the beyond a reasonable doubt standard of proof is needed to closely scrutinize evidence of mental disease and dangerousness.

Tsesis, 68 WASH. & LEE L. REV. 253 (2011)

An examination of the Delaware Code for Health and Safety from CHAPTER 50 of TITLE 16 reveals that it does not utilize the “beyond a reasonable doubt” standard to closely scrutinize evidence of mental disorder and/or dangerousness.

Writing about the landmark case in 1975 (O’Connor v. Donaldson), Tsesis explains why the Supreme Court’s decision placed due process limits on involuntary psychiatric commitments:

The ambiguity of a mental illness diagnosis and the extent to which civilly committed patients are deprived of their liberty rendered the mere diagnosis of mental illness without a finding of dangerousness inadequate to meet due process requirements. Social deviance may make a person the object of animus but cannot excuse restrictions on liberty. Demonstrating an understanding that mental illness was a powerful social label that could be misapplied, Justice Potter Stewart, writing for the majority, asserted that “the mere presence of mental illness does not disqualify a person from preferring his home to the comforts of an institution.”

Tsesis, 68 WASH. & LEE L. REV. 253 (2011)

Comparing involuntary commitments to being imprisoned, Tsesis argues that:

Involuntary commitments are most closely related to criminal punishments because both adjudicate whether respondents whom society has found to be too dangerous should be at liberty. Both involve severe deprivations of liberty.

Without judicial oversight, the potential for abuse is enormous in both areas of law. The [Supreme] Court recognized that civil commitment, like imprisonment, “constitutes a significant deprivation of liberty that requires due process protection.”

Tsesis, 68 WASH. & LEE L. REV. 253 (2011)

Unwarranted deprivations of liberty are egregious violations of a right deemed sacrosanct in this country – the right to be free while operating within the bounds of the law. 

Highlighting the subjective nature of psychiatric diagnoses, Tsesis argues that judicial oversight plays a critical role in safeguarding patients’ civil rights:

The social concern for safety is reflected in the dangerousness component of the involuntary institutionalization test. A state can only confine mentally ill persons who have demonstrated a propensity for dangerous conduct. If mental illness is difficult to prove, the dangerousness element is even more difficult because it involves a prediction of future behavior. …

The need for judicial oversight of involuntary commitments is acute because psychiatric diagnoses rely on professional judgments, intuitions, and algorithms to a greater degree than ordinary medical diagnoses, which have more verifiable biological components.

Tsesis, 68 WASH. & LEE L. REV. 253 (2011)

Tsesis concludes by explaining why the “beyond a reasonable doubt” standard should be utilized when evaluating a patient for involuntary commitment:

The beyond a reasonable doubt standard provides the best means available for evaluating whether the petitioner seeking to institutionalize another has met the two criteria of Addington. Factors tending to show the existence of mental illness and danger to self or others are stigmatizing.  

Unless both can be proven to a near certainty, the liberty interests of the party challenging the commitment should significantly outweigh the government’s interest to indefinitely hospitalize the respondent. 

The clear and convincing standard provides a high probability of proof, but proof beyond a reasonable doubt offers near certainty that civil commitment has not been erroneously imposed. 

Tsesis, 68 WASH. & LEE L. REV. 253 (2011)

Thank you for your time and consideration of this proposal, and heads up that I will be reaching out to each of you by phone to introduce myself, and to engage you and/or your staff directly on the best way to move forward.

Sincerely,

Francesco Bellafante
Creator & Executive Editor
The Nellie Bly Project

Open letter to Governor Carney & the Delaware General Assembly

September 30th

Dear Governor Carney & Delaware General Assembly:

I am a Delaware native currently living in Washington D.C. who is reaching out to you to enlist your help in improving civil rights protections within the mental healthcare system in the state of my birth.

I will follow up with more information next week, but this blog post explains why I want to work with all of you to change the civil commitment laws in Delaware.

Sincerely,
Francesco Bellafante

A stand against tyranny

September 16, 2019

Dear Dr. Marcus,

I hope this email finds you well.

I am reaching out to make you aware of a project that I recently kicked off, and to ask you to have a public conversation with me about the circumstances surrounding your civil commitment of me 17 years ago.

If you’re open to having a conversation like the one I described in my open letter to you (included in the post linked above), please let me know by the end of this week, and we will arrange for a time to connect.  An hour should suffice, and I am willing to compensate you for your time. 

If I don’t hear back from you by the end of the week, I will assume that you are not interested in speaking with me.

Screen Shot 2019-09-16 at 8.10.11 AM.png

Given the noises that President Trump has recently been making about mental illness, I am determined to continue raising awareness about the shortcomings of the system that empowered you and Dr. Ekong to engage in tyranny 17 years ago by summarily stripping me of my liberty, and injecting me with a substance that could have killed me.

If I don’t hear from you, or if I learn that you are unreachable for some reason, I will publish a video explaining in detail why I trespassed at CIA headquarters 17 years ago (here’s a hint), and why I believe that you and Dr. Ekong behaved as you did.  

I will publish that video before the end of next weekend, September 22nd.
I’ve already tweeted this publicly, so I will note it here too. 

Screen Shot 2019-09-16 at 9.06.43 AM.png

I don’t think you made a mistake when you filled out the form documenting the reasons for my civil commitment.  I know that you necessarily arranged for police officers to be in your waiting room prior to beginning your examination of me.  I also know that you lied to my face when you said that I was free to go after you were done examining me.

Frankly, I don’t know or care if you or Dr. Ekong violated a law while treating me, because it is clear to me, as I suspect it will be to many others, that your actions were undeniable examples of tyranny, that is, cruel and unreasonable uses of power or control.

As King wrote in his April 16, 1963 Letter from a Birmingham Jail:

Injustice anywhere is a threat to justice everywhere.  We are caught in an inescapable network of mutuality, tied in a single garment of destiny.  Whatever affects one directly, affects all indirectly.

I hope that you will seriously consider agreeing to publicly provide an explanation for why you civilly committed me, and why you misrepresented the truth on the document describing why you subjected me to involuntary psychiatric treatment.

Thank you for your time and consideration.

Sincerely,
Francesco Bellafante

UPDATE

October 7, 2019

Dear Dr. Marcus,

I hope this message finds you well.  I’m reaching out to let you know that I have decided on a different next step to move The Nellie Bly Project forward.  

Instead of publishing a video explaining my actions in the days leading up to our interaction over two decades ago, I am focusing on working to change the civil commitment laws in the state of Delaware.  

I will be sure to provide you with updates on my progress.

I do remain committed to trying to have a conversation with you aimed at highlighting obvious shortcomings in the system that empowered you and Dr. Ekong to emergently restrict my liberty and inject things into my body, against my will.

Suffice it to say for now, that I believe that both you and Dr. Ekong acted in ways that you both believed were in my best interest.  As I’ve noted before, I harbor no ill-will for anyone involved in my involuntary hospitalization and forced treatment.  

Frankly, I’m grateful for the opportunity to leverage my experience to help improve civil rights protections for people in the mental health care system.

Kind regards,

Francesco