Extended Hold in Psychiatry in New Hampshire Hospital Draws Attention to Pitfalls in Authoritarian Community Mental Health Intervention in the United States

–Ramola D/Update, 10/14/2018:

Not long after this article (below) was published, Robert Cabacoff was discharged from St. Joseph Hospital on 9/11/2018, and attempts to move him onward to a second Psychiatric hospital were dropped. No concrete reason was provided to him nor, Mr. Cabacoff reported, was any apology forthcoming from hospital staff for basic human rights abuses noted herein.

But in a follow-up communication with this writer at the time, Dr. Rohatgi noted that discussions he had initiated with Dr. Biswas, as he had earlier intended based on the special parameters of Mr. Cabacoff’s case had led to his release. 

Mr. Cabacoff suggests that the immediate intervention and advocacy of several of his friends, including retired neurologist Dr. Edward Spencer, as well as this coverage, in conjunction with the clear illogic of holding a perfectly sane and rational person on a fraudulent IEA (Involuntary Emergency Admission) in a Psychiatric ward–after the background situation had been decided in court in his favor were prime factors in ensuring his speedy release.

Also instrumental perhaps was his known intention–gently expressed to staff, along with a two-day refusal of food and medicine–to further explore the irregularities in hospital procedures and protocols he had been subjected to, exert his legal rights, and consult overseeing agencies and human rights organizations in relation to breaches in protocol and human rights abuses he had suffered.  

It is commendable and relieving that Robert Cabacoff was released–after a 15-day stay in the Psychiatric Ward, from August 28 to September 11–but the entire incident of wrongful deployment of an IEA on him on the basis of fraudulent allegations, and the stripping of his basic human rights and civil liberties during psychiatric captivity points to serious flaws in the entire IEA system, in the facile recourse to Authoritarian Psychiatry, in normative jail-like procedures in Psychiatry wards, in the apparently ideologically and procedurally-established inability of physicians, psychiatric staff, and nurses to see a patient admitted to a Psychiatry ward as anything other than mentally unstable and incompetent (despite lack of diagnosis or evaluation), and in the curious alacrity with which Law Enforcement pairs up with Psychiatry to enforce IEAs even on those patently undeserving of such detainment.

–Ramola D/Posted 9/7/2018

In an extraordinary case demonstrating both subversion of legal process and human rights abuse, Robert Cabacoff (73), an avid current-affairs researcher, consciousness-raiser, and retired businessman in the middle of a marital separation marked by his wife’s seeking to oust him as co-owner of their house and mortgage is being held in the Psychiatry ward of St. Joseph Hospital in Nashua, New Hampshire entirely on the basis of allegations–which he says are completely fabricated–of domestic violence brought against him by his wife of many years. An added irony is that these allegations had already been addressed in court and dismissed. Escorted by police to the Emergency Room of St. Joseph hospital weeks after his wife Ana made allegations of being beaten by him as well as being bilked of funds, Robert has been held at St. Joseph for ten days under 24/7 security and in the most deplorable of conditions where he has been prevented from basic self-care such as a shower and a shave for over a week.

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St. Joseph Hospital/Image from Facebook

(Update: As of this posting, after conversations Dr. Edward Spencer, a retired neurologist and friend of Mr. Cabacoff, and this writer had yesterday with Dr. Rohatgi, the attending physician–who agreed that such deprivation comprised human rights violations and sought to change the situation immediately–Mr. Cabacoff reports he was able to shave for the first time in 9 days on the evening of Sep 6.)

Additionally, his laptop has been removed and he has been unable to retrieve personal effects from his own car, even under escort. His only mode of communication with the outside world has been his cell phone through which means he has reached out to family and friends with the surprising news of his incarceration in a hospital ward.

This situation has in fact unfolded on the basis of his wife’s filling out an IEA a few weeks earlier—an Involuntary Emergency Admittance form naming him as mentally unstable and aggressive and requiring immediate mental health care. By New Hampshire law, the filing of such a complaint by anyone requires Law Enforcement to immediately arrest, confine and escort such a person to a hospital for medical and mental health evaluation.

IEAPetitionThis IEA however had already been addressed in court. Post-IEA, Ana Cabacoff had sought an Order of Protection against Mr. Cabacoff, citing fear and endangerment by way of violence and instability and lack of breadwinning capacity; this OP was thrown out of court by the presiding judge after she learned, among other things, that Mr. Cabacoff had successfully operated a remodeling business for 20 years with satellite offices in two states and had saved more than 1.1 million dollars over eight years for his family through pro se litigation and could therefore hardly be draining his wife of funds.

Mr. Cabacoff also flatly denies that he has ever in any way ever threatened or executed any form of violence against his wife.

Despite the judicial dismissal of the earlier OP however, New Hampshire Law Enforcement who apprehended Mr. Cabacoff briefly on a mis-turn in traffic before the entrance to St. Joseph Hospital’s main entrance and later in the St. Joseph Hospital parking-lot, subjected Mr. Cabacoff on identification to immediate arrest and escort to the ER, citing the IEA filing as reason. Mr Cabacoff notes that “this process would be meaningful and helpful in the case of someone really being mentally unstable or unreliable,” but that in this case constitutes a violation of Due Process and is patently unjust since this IEA filed by his wife had already been judicially addressed in court and “should not have been honored under IEA guidelines because the Domestic Violence OP was dismissed.”

Backdrop of Marital Dispute Over Home and Mortgage

This story has a background of marital conflict and disputes over possession of home and mortgage to it. The Cabacoffs have been married for 43 years. Mr. Cabacoff has no history of psychiatric instability or illness. Nor does he have a criminal record or any indication of domestic violence over the course of 43 years. They have both been battling foreclosure on their house for 8 years, with Mr. Cabacoff filing a suit against securitized mortgage fraud by Wells Fargo Bank. Indeed continuous pro se litigation has kept the house from foreclosure. However it appears that his wife’s recent initiation of Chapter 11 bankruptcy proceedings and apparent evocation of laws allowing for mentally incompetent, non-breadwinning members to be removed from mortgages suggest efforts are underway to oust Mr. Cabacoff from the mortgage on spurious charges of mental incompetence.

Knee-Jerk State Mental Health Response to Irresponsibly-filed IEAs?

Part of the problem with such an immediate knee-jerk State Mental Health protocol is that people who become the subject of such allegations—which can be made by anyone, including family members with a vendetta or chip on their shoulder against someone—are treated immediately like criminals and mental patients, and stigmatized as such by the nature of the immediate police action to arrest, remove, and escort someone immediately to a Psychiatry unit in a hospital.

This action also has the effect it appears of influencing Intake social workers, clinicians, and psychiatric staff to view the arrested patient as mentally unstable and potentially dangerous; on the basis of such a presumption, Mr. Cabacoff was immediately put under 24/7 supervised observation. Further a teleconference conducted on September 4 with a psychiatric nurse produced the odd result of a pronouncement that Mr. Cabacoff needed “grounding.” This nurse further noted that Mr. Cabacoff needed to be observed over a longer period and so needed to be transferred for this purpose from Nashua to one of four psychiatric hospitals in New Hampshire. Efforts to obtain information from the nurse on the rationale for her verdict were not successful. “I asked her how she determined such a conclusion. No answer, but alluded to my “viewpoints.” I asked her what viewpoints. No answer.”

Both the attending physician Dr. Rohatgi and the resident psychiatrist Dr. Biswas have relayed to this reporter that they have found Robert Cabacoff to be calm and rational, highly intelligent, well-spoken, and mentally fit, quite at odds with the depiction of him in the IEA petition filed by Ana Cabacoff.

Robert Cabacoff runs an email list with current affairs information and erudite discussion, to which this reporter has subscribed for over a year.

Psychiatry Sits at Odds Today with Preservation of Civil Liberties

Dr. Rohatgi, the attending physician noted that Psychiatry and Mental Health laws have superseded the powers of physicians in hospitals to advocate for patients but conveyed that he was indeed concerned that a mentally fit, contributing member of society should be wrongfully labeled. Dr. Biswas, the St. Joseph psychiatrist on this case discussed with this writer the magnitude of the claim made against Mr. Cabacoff and noted that the deprivation of civil liberties which psychiatric incarceration on the basis of an IEA represented was indeed a large issue, one that had even more significance in a State like New Hampshire, the famed Live Free or Die state.

It is to be hoped therefore that these concerned and conscientious medical staff make the right decision in this case to stave off further redundant psychiatric evaluations and release Robert Cabacoff at the earliest to the resumption of his valuable life and work in his community.

Concerned readers are encouraged to call and express their concern to the St. Joseph Hospital Psychiatry Department. 603-882-3000 is their main number.

Ramola D is a Science, Technology, Surveillance, Military, Ethics, Human Rights, and Consciousness reporter, fiction-writer and poet with 30 years of combined college teaching experience in English & Creative Writing, freelance journalism, management consulting, science & technical writing/editing and training, as well as running creativity and Natural Science workshops for children. She may be reached about this article at ramolad@hushmail.com.

 Related (External Links):

Involuntary Emergency Admissions, New Hampshire

The Right to Treatment and the Right to Refuse Treatment

Involuntary Commitment/Psych Rights by Alicia Curtis/Bad Subjects

Fighting False Allegations of Domestic Abuse

Civil Liberties and Civil Commitment/Psychiatric Coercion Violates Individual Rights by Thomas Szasz

2 responses to “Extended Hold in Psychiatry in New Hampshire Hospital Draws Attention to Pitfalls in Authoritarian Community Mental Health Intervention in the United States

  1. Psychiatric tyranny, when you can be pronounced a goldfish and people will believe it if a psychiatrist or psychologist says so. And no consequences for false accusations. What a racket.

  2. # Release Bob Now

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