Claimant says: "This is a complaint against Chelsea Leigh Sloane, LMFT, CA License #88816. I was evaluated by this MFT in the afternoon of May 21, 2020 while receiving psychiatric treatment in the Emergency Department at Kaiser Permanente San Rafael Medical Center in San Rafael, CA. My evaluation with this MFT was traumatic, unprofessional, and has caused long-lasting mental and emotional damage. Chelsea Sloane came to my re-evaluation unprepared, biased, and eager to inflict emotional pain. I have included Chelsea's numerous violations of the CAMFT's Code of Ethics that she committed during her encounter with met throughout this claim.
On May 20, 2020, I had a treatment session with my outpatient mental health therapist that ultimately resulted in her calling the police to my home and me being held on a 5150 hold. I had been seen via telehealth by another clinician who had officiated the hold on the afternoon of the 20th, and on the morning of the 21st, I requested to see another clinician from the Psychiatry department, as my father had arrived from out of state in order to stay with me so that I could be discharged. My ED doctor, on the morning of the 21st, reported that I would be evaluated by Chelsea at some point that afternoon, but to be aware that she had told him that she was not going to lift the hold, regardless of how I was feeling or what I said (violation of Section 10.5). Later, I found out that several nurses in the ED knew this information as well. That an MFT could be so callous and self-righteous in communicating about a mental health evaluation, and having the audacity to even insinuate that she would make a decision about my care prior to performing a scheduled procedure, clearly has to be beneath the profession of Marriage and Family Therapy. It is also indicative of an individual who may think far too highly of themselves for their given rank in a medical setting, which can lead to reckless behavior and difficulty participating on a multidisciplinary team.
Chelsea began her appointment via telehealth. Her note states that she reviewed my Patient Rights with me, which is untrue (violation of Section 3.1). This was never mentioned at the start of the appointment and never mentioned at any point afterward. I was also denied a patient's rights advocate during my hold in the emergency room, despite explicitly asking for one. Chelsea then asked me to review the circumstances that led to me being in the ED. Chelsea repeatedly omitted, misrepresented, or otherwise poorly documented my contributions to the appointment to ensure that her documentation aligned with what she had initially reported to my ED physician (violation of Section 5.3). As an example, Chelsea wrote the following: “Patient reports that yesterday she thought that ‘by saying all of the right things I'd get to go home, and if I was cooperative, calm, and seemed polite that that would work in my favor.’
It is possible that I used some of the words that Chelsea details here at some point during my hospitalization. However, throughout the entire evaluation period, Chelsea gathered her documentation by pen/pencil and paper. I am certain of this because I watched her. I am also a state-licensed, nationally certified speech-language pathologist by training, and I can assure you that to hear and immediately write down verbatim a sentence of that length and clausal density with perfect accuracy would mean that Chelsea has genius-level working memory and verbal language skills. My encounter with her and subsequent inspection of her clinical decision making skills confirms that this is not the case. Alternatively, it could mean that she recorded the evaluation, without my knowledge or consent, to obtain that quote; that a scribe was in the room without my knowledge or consent and the presence of whom Chelsea did not disclose; or perhaps, Chelsea simply just took some creative liberties when reporting my words during our encounter. The latter is what I believe is the most likely.
Chelsea Sloane knew she would be able to do this successfully because she could hide behind a screen, unheard by the security guard on the other side of the glass door of my hospital room, and neither the nurses nor the psychiatrist would question her notes. State law would ensure that she would be protected from private prosecution. Precedent would ensure that because almost everyone who is held stays the whole 72 hours, she would not be found suspicious for keeping me in the hospital (violation of Section 4.7), even though she knew I had a family member minutes from my hospital room who would be able to stay with me. Descriptions of my mood as “labile” would protect her when I reported to my nurses how she abused her power to make her job more convenient, or even that her treatment of me was upsetting. Ironically, Chelsea's mention of lability in this context only undermines her credibility and further demonstrates her lack of training in neurology, human physiology, and medicine, because she does not appear to know the word's true definition in a clinical context.
I reported to Chelsea that in my therapy appointment on May 20, I lamented that my treatment was not working. This was not surprising information to my outpatient therapist; I was feeling disappointed for weeks about it. I had called Kaiser and spoken to many of Chelsea’s colleagues, begging to be placed in a higher level of care. No one helped. I told my therapist that I didn’t know what to do, and that it was cruel to expect patients to continue doing everything themselves with respect to treatment when no one would help them. I asked her why she wouldn’t help, and why no one else would. For some reason my outpatient therapist interpreted those questions to be rhetorical. I became angry, as these were literal questions. I told her this. She continued to evade my questions. I got angrier; she was not helping. I told her that this is exactly why treatment was so hopeless, and why there was no more for me to get out of it. Things escalated from there. I explained this to Chelsea.
Chelsea’s documentation reads as follows: Patient continues to endorse intense feelings of hopelessness and ambivalence about future treatment, given her feeling that her many years of treatment have been unsuccessful. Patient's reports that her therapist called police due to a misunderstanding about a boundary that Patient set. Patient's therapist allegedy [sic] crossed a boundary by inquiring about Patient's future and trying to engage the Patient in future oriented care. Patient states that I can't go there in regards to any future talk or future planning, and expressed anger that her therapist wanted to discuss this.
Chelsea both lied and fundamentally misunderstood the situation at hand. My therapist did not do any of this. My therapist “inquired” about nothing; “engaged” about nothing. I initiated the topic; also, this would make no sense, as I, not my therapist, was the one who had attempted to officiate a higher level of care and been stopped. There are countless documents proving this, and they were visible to Chelsea at the time of my hospitalization. Chelsea’s documentation, throughout my entire hospitalization–again– includes massive violations of section 5.3: Client/Patient Records, with fraudulent and deliberately misleading claims. What Chelsea’s notes also neglect to include is that less than two weeks before this encounter, I had filed an expedited review with Kaiser to demand residential mental health treatment. Kaiser denied my request, pending an evaluation with a psychologist in another Psychiatry department in another region. That clinician then denied my request to higher levels of care as well. Chelsea should have easily seen that I was very actively pursuing more intensive care for myself, which either makes her negligent or deliberately distorting the truth. I was even trying to explain this to Chelsea during the evaluation and she repeatedly interrupted and stopped me from speaking (violation of Section 5.10). Her choice to omit this from her notes is an egregious act of misconduct. Note also that she pathologizes my hopelessness, characterizing it as a symptom of mental illness, because she ostensibly lacks the differential diagnosis skills to wonder whether this might be a normal reaction to being denied necessary care and being neglicted, then having everything blamed on you as the patient.
In addition to falsifying information, Chelsea obscured information as a tactic to not overtly lie, but to portray me as less rational or more bizarre, and maybe more deserving of hospitalization based on those grounds (violation of Sections 4.7, 5.7, and 5.9). Chelsea notes, seemingly out of nowhere, that, “Patient feels that looking into organ donation/viability and will planing [sic] are totally normal and highly valued in my family yet has little insight into how this could be seen as highly concerning in combination with her current psychiatric crisis and suicidal ideation.” I can assure you that I have, and would have had at the time, plenty of insight into just how incoherent this statement is, and in an attempt to shed light on it, I will say this: being an organ donor is something that normal people are exposed to thinking about every few DMV visits. I have been one for over 13 years. Proudly. One thing that prevents me from killing myself, though I am very depressed, is the moral offense I would commit by not donating my organs. I take it very seriously. That mindset kept me alive at various times in life. Additionally, in my family, death is not a taboo subject. They talk about it and plan for it, and avoidance is seen as naïve. Death can happen by falling off a curb or choking on your dinner. They decide early what they want– cremation vs. burial, where their ashes will go, whether they’ll have a DNR, what charity they want the remains of their bank account donated to– and tell people clearly what they need to do in order to take care of them; that’s what my family does. I may have been too upset to articulate myself exactly like this to Chelsea in the hospital, but the way she twisted my words to continue my detention is unforgiveable, whether due to ignorance or malice. Also, looking into organ viability is meaningless. I outrank Chelsea in an acute care setting as a speech-language pathologist and have far more healthcare-specific training than she does, so she is out of her scope to comment here. The idea that with my career and knowledge I would think that somehow I would be able to kill myself while simultaneously procuring my own organs for donations only strengthens the argument for keeping unqualified MFTs like Chelsea outside of emergency rooms (something I wholeheartedly endorse), and cannot be taken seriously as an imminent risk for suicide.
Additionally, Chelsea’s writing seems to imply that it is the job of the patient or mentally ill person to phrase things in such a way that they are perfectly tolerable, clear, and innocuous to the provider, and that to do otherwise is to lack awareness or perspective-taking skills. This is yet another display of Chelsea perhaps unethically taking on an assessment for which she lacked training and competence, because her assessment of insight appears to be primitive at best. I might instead argue that if Chelsea is expecting requisite caretaking behavior from her patients while in psychiatric distress, that she might be a dangerously poor fit for emergency healthcare, mental health care, or even anything in the human services field. I find her words particularly offensive because many of my own patients have an enormous variety of communication deficits, and my colleagues and I manage to care for them, holistically, just fine without blaming our misinterpretation of one thing that they may have said. If that logic was a major component of what locked me in the hospital, it was cowardly and wrong. I should hope that the field of Marriage and Family Therapy does not allow that line of thinking, because I can assure you that no other profession does. It is not my job to babysit Chelsea’s language comprehension skills; her documentation should show you that I cannot, even if I try to. ANd it should not automatically reflect poorly on my insight. This thoughtless argument went into deciding that I should be hospitalized against my will. It was also a massive violation of Sections 4.7, 5.9, and 5.11.
Chelsea omitted significant aspects of the evaluation that were highly inappropriate and felt overwhelmingly manipulative. In her report, Chelsea mentions that, “Patient would not allow this writer to reach out to her father other than to only confirm that he would be staying with her. Patient would not allow this writer to discuss thorough safety planning.” In reality, I said that I would be open to Chelsea talking to my father, but I would like to be informed of what she would discuss and how much could be kept confidential. Chelsea appeared visibly irritated upon hearing this request (violation of Section 3.1). Chelsea was evasive and vague, ultimately replying that she would inquire about the extent to which my father was familiar with my “treatment plan.” She adamantly refused to elaborate. I was certain that she had no clue what my treatment plan was in the first place, if for no other reason than because Kaiser clinicians in San Rafael were planning to meet to discuss what changes were about to be made. Also, I do not know if “patient would not allow” was meant to evoke an image of me physically threatening Chelsea if she discussed safety planning– something that, as someone who has been in treatment for 15 years, I know perfectly well– but it is pathetic to blame your failure to perform a vital part of your job on your patient. There is nothing I could have done to literally prevent Chelsea from discussing safety planning. I was mere feet away from a security guard, and Chelsea was communicating with me remotely. Chelsea also misleads in her report by placing the greatest weight on my father, when Joint Commission standards for safety planning clearly revolve around the patient. It is clear, again, that Chelsea is not competent to safety plan, may not in fact know what it entails when implemented with fidelity, and has not been trained according to Marin County's guidelines.
While I understood that limiting access to weapons, ensuring adherence to medications, supporting attendance to follow-up appointments, and general social support would have been reasonable to expect of someone who would be picking up a hospitalized psychiatric patient, I was appalled that Chelsea felt it appropriate to display this conduct in an evaluation. First, I was desperate to be discharged, and she was exploiting that (violation of Section 4.7) in order to avoid placing limits or boundaries on herself to protect my privacy and dignity with my own family member. Her irritability, complete unwillingness to consider my perspective (violation of Sections 5.7 and 5.9), and subsequent impulsivity resulted in her abruptly abandoning the topic of calling my father altogether, interrupting my earnest attempts to explain why I was concerned by her proposal. “She had just met me, and respectfully, she hasn’t seemed like she has done her homework on me at all,” I thought; “does she even know I have a psychiatrist? He works at Kaiser too and Chelsea probably knows him. Had he even been called? Does my dad need to know when my appointments are?”
Chelsea also completely overlooked the fact that my “treatment plan” was about to completely change once I won my fight for residential care, but according to her, I was in denial that I needed treatment. How could I trust her to talk to my dad, who lived in a different state, from whom I was financially independent, and with whom I did not discuss my psychiatric care? Why was she expecting that he would know details about my care? I am 28 years old– was Chelsea expecting him to have kept up with my sexual healthcare too? Did you, dear reader, share all of your intimate healthcare information with your parents at age 28? Did Chelsea think that dads still actively “parent” a 28-year-old, or that he would need to sign off on my Cymbalta prescription? Why would she think it would be helpful if she quizzed him? Chelsea was asking me to give up control of my medical information in order to regain my freedom. She exploited me, abused her power, and knew exactly what she was doing.
I burst into tears trying to decide between my dignity and my civil rights. Chelsea was showing me nothing but hostility, treating every clarifying question I asked as a gesture of noncompliance. I asked her if she would still let me go home with my dad, even if he got her quiz questions wrong. I told her that he cares a lot about me, but if she was looking to fail him on a technicality, that would be unfair. Sometimes he forgets if my birthday is on the 8th or the 9th– he’s not going to answer really detailed questions perfectly, I told her. She accused me, as she noted in her report, of trying to get a guaranteed discharge, and she tried very hard to make me seem irrational, devoid of insight, and riddled with anosognosia for asking for one.
At this point, I brought up yet another conversation topic that Chelsea failed to include in her report. Kaiser San Rafael Medical Center is in Marin County, minutes from where I grew up. As a healthcare worker myself, I am familiar with Marin’s involuntary hospitalization guidelines, and that they involve not only the state’s 5150 threshold, but also the expectation that people being held are only done so involuntarily if they are a present, immediate, substantial, physical, and demonstrable risk to themselves, in my case. Marin urges people to consider that the law states that you “may” place a hold, not “must.” I even went to the effort of pulling up the guidelines on my phone during the evaluation and briefly reviewing them for Chelsea during the evaluation, as I had not yet been informed of her rationale for maintaining the hold, particularly without even seeing me first (violation of Section 3.12).
I calmly explained that even though she may be looking to meet the 5150 threshold to keep me in the ED, I was raised in Marin County and was currently hospitalized there, and I deserved to receive the extra protections that my county provides. Suitable 5150 examples in the County are deliberate overdoses, or when someone wanders into traffic. I politely questioned what imminently impulsive act or plan she accused me of carrying out, and reminded her that she had never asked what I was doing in the hours (laundry, talking to my trauma therapist and dad, watching TV) or minutes (LA Times crossword from the past Sunday) before the police arrived. I explained that I am a licensed professional who works full-time in an extremely procedure-intensive role, also in a hospital. Chelsea looked angry and cut me off from talking. To this day, because I was evaluated via telepractice, I do not know whether Chelsea’s home region was also Marin County; she may not have been aware of the county’s hospitalization guidelines, which would be a violation of Section 6.2.
Chelsea then began attacking and belittling me, attempting to point out all of my “flaws” as a patient and, evidently, reasons that I needed to stay in the hospital (violation of Section 5.10). She claimed that I refused to create a safety plan with my therapist while working with her. She is lying; what she shoudl have said is that I refused to contract for safety, an outdated intervention with no evidence base for use in the emergency room or for therapeutic relationships like the one I had. I stated that because I’m an adult, I declined the option to contract sometimes, as is my right, because I find it triggering and infantilizing.
Chelsea then began to berate me about declining consents to releases of information to my previous therapists– again, she angrily refused to detail what kind of information she would request from them when I inquired. This was just another tactic to blame the outcome of the evaluation on me and lessen her workload. My evidence and attachments from the other complaints will very clearly present that I signed releases of information for Kaiser clinicians to correspond with both of my therapists on May 14. Chelsea would have been well within her right to contact them without asking me beforehand, and she probably should have in order to actually get accurate information about what happened. I suspect that she designed the situation that she did, and evaded my questions, in order to avoid having to call them and spend more time on my evaluation than she had to. It had the added benefit of making me look noncompliant. Chelsea also mentioned in her note that I refused to engage in thorough safety planning with her. This is a lie, as “thorough safety planning” was not offered to me during the evaluation (violation of section 3.1). If it had resulted in me possibly leaving the ED, I would have jumped at the chance.
While I admit that I cannot know this for sure, I believe that Chelsea made harmful assumptions about my experience with mental health treatments, knowledge about my diagnoses, mastery/repertoire of coping skills, and awareness of functional limitations based on my young age (violation of Section 5.7). I have been in treatment for over 14 years. Her criticism of my practice of therapy was ill-timed, unsolicited, and irrelevant to the evaluation. I can respect that she disagrees with the choices that I make for myself in treatment, but she did not respect me (violation of Section 3.1), and no choices resulted in imminent harm. I am trained to know how to respond to bombs, fires, cardiac arrests, child abductions, active shooters, and countless other disasters in my line of work; to insinuate that I lack the knowledge or ability to plan for suicidal thoughts is simply insulting and absolutely outrageous. I observe my own patients making safety plans with counseling staff in my hospital. I make plans with them too. Chelsea did not ask about any of this because she did not want to know. She wanted to portray me as someone incapable of employment, emotional regulation, and independence. And when I tried to tell her, she would not let me speak.
Chelsea then said that she had all of the information she needed, that she would consult with a psychiatrist, and return to let me know the status of my 5150 hold. I was devastated and felt completely violated. I began to panic, called my dad, and told him to tell Chelsea whatever she wanted to hear when she called. I confessed, through sobs, things about my mental health that I was nowhere near ready to tell him or anyone else in my family. I called my nurse and told her to tell Chelsea that, fine, she could call my dad and ask him whatever she wanted, however invasive. I just wanted to go home.
When Chelsea came back and reconnected via video, she told me that she recommended that I continue to stay under a 5150 hold. I begged and pleaded for her to call my dad, said that she won, that I would forfeit my privacy. I asked her how she managed to keep the hold when she had no evidence of imminent harm and hadn’t actually asked me any questions that met any of the requirements. Chelsea said that a big part of it was that I had too many “rules” and “limits” on her calling my dad (violation of Section 3.1). I told her that I had changed my mind, and that she could now do whatever she wanted. Chelsea looked annoyed, and ultimately refused. She then said that the hold was to “keep me safe.” As Chelsea stated in her note, I told her that I did not believe she cared at all about my safety, and that she was lying. I stated that it was triggering to hear, because I felt traumatized and she made me feel less safe than I had been all day. She shrugged her shoulders and repeated herself. Chelsea demonstrated that she was not fit for work in the ED, and certainly not with patients with severe PTSD, by repeating behavior that a patient stated was triggering (violation of Section 5.11).
Chelsea’s behavior and ethical infractions would never be tolerated in any clinical department, hospital, licensed profession, or healthcare association that I have ever known. I would be terrified to have her on staff in my hospital, and I am perfectly certain that my colleagues would be too. I am particularly concerned about Chelsea’s work in the Emergency Department in the future. After being her patient, and as someone who works in acute care, I believe that she lacks intellectual and emotional knowledge of the stress and lack of control patients tend to feel in the ED, and that it requires an ability to interpret behavior that is above her skill set (violation of Section 5.11). Chelsea is prone to making broad generalizations based on little information or observations, and the ED can bring about outlier behaviors in otherwise normal individuals, which may distract Chelsea or lead her to over-diagnose. Chelsea also becomes easily irritated by questions from patients and struggles to explain her plans, which is unacceptable for people who are likely already feeling some loss of control by being in a hospital bed.
I understand that everyone has tired, stressed, and just plain bad days– even those of us with jobs where we really need to check our baggage at the door to perform at our best. This was not the conduct, mentality, ethics, affect, or judgment of a good therapist on a bad day, though. This was someone dangerous– to the Emergency Department, to Marriage and Family Therapy, to mentally ill people like me, and to the State of California. This was someone without any sense of awe, weight, or humility while they kept my civil rights from me. This was someone without any compassion, empathy, or anything more than simple awareness that she was causing enormous trauma that would never heal. This was someone who was abusing her power because she knew all too well that her patients would be perceived as far too sick, manipulative, unstable, and unreliable to be trusted. This, perhaps most importantly, was someone who lied. No other individual, regardless of how sick they are, deserves to feel the kind of pain that I feel due to Chelsea Sloane’s misconduct.*” ...Show less »