Opinion ID: 1679508
Heading Depth: 1
Heading Rank: 1

Heading: griffin's commitment to bryce

Text: Griffin's alcoholism and substance abuse since 1977 led to his civil commitment to the Bryce facility on April 11, 1983, by the Fayette County Probate Court on a petition filed by the Northwest Alabama Mental Health Center. Upon his admission to Bryce, Griffin was examined by a staff physician and a staff psychiatrist; the staff psychiatrist entered an initial diagnosis of adjustment reaction (stress reaction) with mixed emotional disturbance and continuous alcohol dependence. Griffin was given the prescription drug Ludiomil for depression. His initial treatment plan listed the following criteria to be met for his release: Active involvement in the substance abuse program; control of depression for one month; willingness to attend recommended follow-up by a community mental health center for regulation and supervision of medication; and possible involvement with Alcoholics Anonymous. The Bryce Substance Abuse Unit (the unit) provides specialized treatment to persons requiring short-term residential services for substance abuse problems. The unit averages 300 admissions and discharges per year, or about 25 admissions and discharges per month. At the time of Griffin's admission, James Harpole was coordinator of the unit; Dr. Paul was employed as a clinical psychologist in the unit; and Dr. Barnes was employed as a medical doctor assigned to the unit as administrator, with authority to sign admission and discharge papers. [2] Each admittee is assigned to an interdisciplinary treatment team, which examines and evaluates the patient; gathers relevant history on the patient; formulates and administers a treatment plan; and assesses the patient's progress. Griffin's unit treatment team was comprised of Harpole; Dr. Paul; Dr. Barnes; Dr. Sally Watkins, Terry Aplin, and Sheila Blacksher (social workers); Barbara Kemp (a nurse); and Sharon Bowden (a qualified mental health professional). On April 18, the treatment team met with Griffin to assess his current status and formulate a master treatment plan to identify his existing problems and provide any assistance that could facilitate his eventual discharge from the unit. The team, aware of Griffin's history of alcoholism, substance abuse, past treatment, and his personal and work life, identified a working diagnosis of alcohol dependence and substance abuse as his only psychiatric/psychological problem. Short term goals set for Griffin included achievement of level III, which would provide him with a greater degree of hospital liberty and with job skills evaluation. Long term goals sought to have Griffin remain alcohol and drug free; develop independent living skills; and establish a work history. Criteria for Griffin's final release from Bryce included remaining alcohol and drug free; achieving level III; contacting a community mental health center for follow-up treatment; and having a job placement. Griffin's estimated release date of June 1, 1983, as set forth in the initial treatment plan, was left unchanged by the team. After admission, Griffin was administered a battery of psychological tests to provide an indication of his current level of intellectual functioning, the presence or absence of organic disturbance, and personality structure or functioning. The psychologist's report, in addition to emphasizing Griffin's alcoholism, stated that he did not exhibit the type of thought disorders typically found in schizophrenic or psychotic individuals, but noted his antisocial behavior and tendency to blame others for his problems. On April 22, 1983, the Northwest Alabama Mental Health Center reported to Harpole that Griffin's wife had received a handwritten letter from Griffin. The letter stated that he was feeling bad [and] they are giving me [something] and it makes me [sick]; that I love you so much I am going to kill myself but [first] I am going to kill a lot of [people] it [might] not be you I don't know; that I think bad but try not to but I can't; that I love you and the kids but don't [know] what will happen so look out if I [sneak] out of here; and that I am not going to be here long [because] I am going to [sneak] out. A private psychiatrist, employed by Bryce, evaluated Griffin on the evening of April 22 to determine whether Griffin was a threat to himself or others and whether the substance abuse unit was the most appropriate placement for him in light of the letter. Griffin denied that the threat was serious, indicated that he had no intention of killing anyone, and stated that he planned to remain at Bryce and complete treatment. Griffin was placed in a secure ward under close observation; the staff psychiatrist who examined Griffin at the time of his admission to Bryce evaluated Griffin on April 26 and, in conjunction with the private psychiatrist's notes and conversations with Griffin, concluded that he was not a suicide or homicide risk. Griffin was then transferred back to the unit. Griffin requested discharge from Bryce in late April or early May of 1983. The treatment team believed that Griffin had experienced a significant change in his response to the treatment program after the letter incident. He recognized that marital difficulty was a central factor in his behavior; and he expressed his intention to seek vocational training, to affiliate with a community health center, and to refrain from using alcohol and drugs. Before acting on Griffin's discharge request, however, the treatment team referred him to the staff psychiatrist, who had twice examined him, for further psychiatric evaluation. The staff psychiatrist concluded that Griffin was competent, not suicidal, not depressed, and not a danger to himself or others. In response to questions from the treatment team, the psychiatrist affirmed that Griffin was competent to make decisions and was able to be released from Bryce. The treatment team considered Griffin's progress to have been adequate and consistent with the goal that he attain level III, as provided in the treatment plan; it was also felt that Griffin did not have any mental problems other than his drinking and related behavior. On May 4, 1983, Griffin was released from Bryce into the custody of his father. Dr. Barnes signed the discharge papers and provided Griffin with a two-week supply of Ludiomil, the antidepressant prescribed for Griffin at the time of his admission to Bryce. At the time of his discharge, Griffin's prognosis for staying off alcohol in the future was guarded.