I have come across a couple of people who have been considering Ashburn Clinic, a private 'therapeutic community' in Dunedin. I hope in this entry to give a personal opinion of Ashburn, developed during a four month stay there, which can hopefully be of use to those considering it.
Keep in mind that my opinion is biased, as I, like many others, was kept there under threat of being sectioned. I will endeavour to be honest, fair and open-minded, and to provide as many examples to prove my criticisms.
Firstly, I want to acknowledge that the Ashburn Clinic has been a positive turning point in many peoples' lives; whether suffering addiction or illness. I have seen people in Ashburn Clinic who, if they had not received treatment, would certainly have died (through suicide or otherwise).
My therapist, Michelle, was a lovely person, adept at helping me to understand things. I did some important work with her. Typically, as an inpatient at the Ashburn Clinic, one has individual therapy twice per week, in two 45min sessions. Individual therapy is considered an important, but very small part of the overall 'work' done at Ashburn.
On entering Ashburn Clinic as an inpatient, you are assigned to one of the two units; Gwen Wilson, or Frank Hay (the ward where all those with eating disorders are placed). You are appointed a psychiatrist (or psychiatric registrar), and a therapist. My psychiatrist was Dr. Brett Ferguson, and my therapist was Michelle.
You will initially be placed in one of the downstairs bedrooms, closer to the nurses' stations on either units, and will be on half-hourly observations. Depending on what your medication needs are, you will have to wait outside the nurses' stations at the appropriate times. Night medications are typically given at 9pm, after hand-over. Beware, because if you forget your medication, it is unlikely that staff members will remember to dispense it to you. This was a problem that occurred multiple times during my stay; owing to my absent-mindedness.
It is a staff decision what parts of the program you will be included in initially. Unit meetings are group meetings in which the Frank Hay or the Gwen Wilson unit patients and day staff meet seperately. One person acts as chairman and names absences and leavings, asks for volunteers for 'ward cuppa', and organising sport and rec. activities. Discussions are also initiated about: who is on half-hourly, or hourly observations, and who is on a 'graded activity program' (activity restriction programs for the eating-disordered patients). Who is on observations is decided by the patient group (but in my experience can be vetoed by staff members). Before the entire patient group of the unit, people on half-hourly or hourly observations are asked how they are going, how safe they feel, and may ask to go off obs. Details of the patients' behaviour are encouraged to be shared by the staff members, and one gets the feeling that nothing is truly confidential at Ashburn Clinic.
Community meetings are held in the mornings, twice weekly. Occasionally, they are held as per requested by staff or patients for various issues. They include almost all of the day staff, therapists and psychiatrists, and all of the patients from the Frank Hay, Gwen Wilson, and the unit for those who have moved 'up the hill' to the staff-free flats and who attend the day program. Unless called for a specific purpose or issue, the community meetings have no 'subject'. Patients often 'own up' to disordered behaviour (i.e. drinking, self-harm, suicide attempts) in these meetings (or alternatively, staff members tell without asking for permission). Sometimes, an empathetic and caring response is generated from the patients (although efforts to be empathetic and caring are often deemed "trying to make things nice"). More often than not, a negative response is received. Often this negative response is initiated by the staff members themselves. I have been in meetings in which patients have sworn at other patients. Many meetings involve verbal abuse of patients, beneath the euphemism of a 'challenge'. Needless to say, it was humliating to be heavily criticized by the staff members for my binge/purging in front of that many people (as was done on the 6th March). I left the meeting feeling like a criminal and hating myself even more for my behaviour.
In my opinion, there is a complete lack of confidentiality, trust and safety within the community. If staff members aren't outright sharing confidential details of patients illnesses with other members of the community, they are implying it in order to 'cover their tracks'. Things like the numerical details of other patients weights, weight gain/loss, are openly discussed between staff and the community. I find this particularly unhelpful, so after Scott shared the details of another patient's BMI, I politely asked him one-on-one, if he would mind not discussing such things in front of me. I was told: "I'm not going to wrap you in cotton wool.", and that was that.
In my opinion, the Ashburn Clinic violates a number of patients' rights under the Code of Health and Disability Services Consumers' Rights. Firstly, the right of respect. The following are quotes said either to me or to other patients there during my stay:
“All of the anorexics are one-eyed and deaf-eared”
“Are you thick?!”,
“You can starve yourself to death for all I care!”,
“You’re a bully. Nobody wants you here.”
“You’re obviously trying to undermine the whole community.”
”You’re sick. You’re really sick.”
“You weren’t sick; you were perfectly in your right mind.” [said to the same patient within a short time frame]
“You must have misheard.” [on questioning about abusive comments]
“I think she seems to find this quite exciting.” [about a very physically compromised patient]
“You are destructive to the other patients.”
“I think we’re trying to find a bad guy here.” [when people start questioning the staff, this is generally the response]
I feel that these are very disrespectful, and in some cases downright abusive.
The privacy of the patient is also to be respected. This is not the case in the Ashburn Clinic as I experienced it. For example, Joyce (nurse) repeated a conversation that had been held in private, in front of the patient group. Dr. Brett Ferguson and staff sharing things that had been said in confidence in private sessions with him. On a number of occasions, staff members will actually peer and look over the patient's shoulder at the computer screen. Privacy is discouraged within the community, and not wanting to share humiliating illness with the group is considered 'trust issues'.
As I have said, Ashburn does work for some people. But I feel that for the few people who do benefit, many more are damaged or hindered in their recovery.
Whatever your path of choice for recovery, I wish you the best of luck.