It’s been seven years since a ChristianaCare physician lied, gaslit, and coerced me into agreeing to psychiatric hospitalization. Here, I share the grievance I filed with ChristianaCare’s Patient and Family Relations department two years later. As the system continued to gaslight, abuse, and neglect me, I learned that this is “standard treatment”; it’s how they treat the majority of distressed people who ask for help. I hate to think how many others have been deeply and egregiously harmed in the name of “mental health.”

Submitted June 30, 2020:

In recognition of PTSD Awareness Month, I file this grievance against the ChristianaCare ED/Psych ED for neglect of a patient in great need of care for Complex PTSD. The harm it caused me is so wide and deep that I am only now able to prepare this document, two years later.

What Happened:

With my Complex PTSD/Developmental Trauma untreated due to an uninformed and inattentive psychologist, and denied the pharmacogenetic test that would have prevented the Rx toxicity issue, I was routed onto the Trauma Train Express. ChristianaCare’s Foulk Road Family Medicine psychologist had been unresponsive, so I called my PCP about the increasingly intense suicidal ideations that began a few weeks after I started taking the Lexapro she had prescribed. Unlike the psychologist, Dr. Kucuk actually listened and recognized the danger those pills posed. My PCP firmly advised me to stop Lexapro immediately, never take it again, and go to a hospital ED for a psych evaluation ASAP.

2018-06-27 – I went to Wilmington ED where they took my clothes and personal belongings without notice. This included my phone, so I could not make even one call. That was highly distressing! Nobody explained what would happen, what to expect, or who would help me. Because nobody helped. Instead, they left me overnight in a cold room with nothing but a chair. 

According to ED records, my so-called “psych evaluation” was conducted by Stephen Koczirka, MD. He asked about the SI, which did not involve any suicidal intent. Nonetheless, the doctor told me I had “a plan.” He said I should go to Rockford; inpatient care would be helpful, a gateway to services, like art therapy and a psychiatrist on the outside. I said I was afraid. He asked what I thought it would be like. “Cuckoo’s Nest!” I said. He assured me it was not. This was coercion and gaslighting.

Sometime that night or early morning, Psych ED staff retraumatized me when they subdued and sedated another patient, one whose distress they escalated instead of helping her de-escalate. She was screaming, “Get off me! Get off me!” just like I did when pinned down by abusers. Of course, witnessing her trauma gave me a horrible flashback! I was crying and shaking in terror. Afterward, the subduers stood around just outside the door to my room, which extended my distress reaction. I felt trapped! Nobody bothered to check on me. It’s like I wasn’t even there. Later, I told a staffer how badly I was triggered, and he looked at me like I was speaking gibberish. Staff response to my distress was absent.

When a distressed person is treated like an object, it’s not care, but warehousing and profiteering off human misery.

Lack of appropriate care/intervention in the systemic push toward unnecessary incarceration at Rockford, a facility owned by a company known to violate patient rights, as it makes great profit by cutting staff and patient services. 

Effect on Me as a Patient/Healthcare Consumer: 

Wilmington Hospital Emergency Department exacerbated the problems that began at CCHS Foulk Road Family Medicine. Wilmington ED did not give me anything helpful, but plenty of harm. It was not a safe place for me, but a triggering, abusive, neglectful environment. It threw me into a highly challenging and detrimental situation that repeatedly retraumatized me. It offered no treatment, care, or even basic support. It funneled me to Rockford Center for Behavioral Health, where I experienced and witnessed violations of patient rights, unsanitary conditions, neglect, overcrowding, roach infestation, and voluntary patients held against their will. Also obvious were unsafe staffing, inadequate training, and dismal nutrition. Conditions at Rockford were as described in the enclosed BuzzFeed investigative report about the the parent company, titled, “What the Fuck Just Happened?” These hospitals are insurance milking machines that violate patient rights and do not provide appropriate care or housing. I did not need to be there, and I was sent there due to ChristianaCare’s systemic failure to provide appropriate care. This caused me needless harm, set me back tremendously, and made recovery an even greater challenge.  

The unnecessary hospitalization for an iatrogenic condition robbed me of things that help my mental and physical health. A scheduled medical test had to be put off for another 3 weeks, so I was uncomfortable for an extra month and a half for no good reason. I could have spent that week sailing my ship, hanging out with my shipmates, enjoying a pool party, going to the sing-along sea shanty event, and I would have had the energy to keep my promise to help put on the Pirate Festival. Instead, I was wiped out from trauma, trauma, and more trauma, and the pharmaceutical cocktail. Any of those activities would have been far more therapeutic than a week in the nasty so-called hospital into which your system pushed me. 

Seven years later, those events still have sizable negative effects on my mental and physical health. My Complex PTSD has accumulated and compounded, as it does for anyone who is repeatedly harmed and not helped. The damage disabled me from being able to sail my ship at all, so I miss the benefits of community, camaraderie, a positive social environment, voyages to look forward to and enjoy, and physical activities that maintain strength, flexibility, and endurance. These losses are HUGE, particularly at my age. 

From my vantage point, Wilmington Hospital abused me just like my prior abusers. It used my vulnerability and my need for something greatly important only to hook me in with its deception and then exploit me for its benefit. The abuses and retraumatization set me back a great deal. The maltreatment I received from Wilmington Hospital was unnecessary and unacceptable. I shudder to think how many others, often even more traumatized, continue to be ground into sausage due to willful neglect. 

What Should Have Happened:

ED staff should have told me in advance what was going to happen, and given me some time to make at least one phone call.

Psych ED staff should have been trained and acted according to Trauma-Informed Care (TIC) protocols. They should have actually assisted the people in distress, not amplified their distress! 

They should have actually provided a 1:1 sitter. Somebody trained to help people lower their distress levels. Seriously.  (Plus, that smells like billing fraud. Just saying.)

They should not have not written in the notes, “Plan: #1: 1:1 sitter,” because there was no “caregiver who provides patients in need of supervision with companionship and care.” Within those walls there was nobody and nothing even designed to actually help me or anyone like me. That is not care, it’s abuse by omission. 

Dr. Stephen Koczirka should have listened to me instead of telling me I had a suicide plan. I did NOT. I went to the ED because I did NOT want to die, and because I was afraid of the SI caused by the Lexapro. That is not “a plan,” it is a known adverse reaction to this Black Box medication. One that the prescribing physician failed to mention. She also failed to implement the FDA-recommended protocol for this medication, which is flagged due to “increased risk of suicidal ideation:  “Monitor for clinical worsening, suicidality and unusual change in behavior, especially, during the initial few months of therapy.”

Dr. Koczirka should have refrained from trying to talk me into going to Rockford. He should have made sure I was given care instead of incarceration and MORE harm. The doctor should not have dismissed my need for safety and care. With this kind of “care,” most traumatized people are going to go away. They might even just give up and die. Some will commit suicide out of futility. Why keep going, if the system and people you turn to for health and care, harm you further? 

None of the harmful events would have happened if ANYONE in the ChristianaCare system had been attentive and had  listened to me. What I said all along and was proven by the disappearance of the SI in less than 72 hours after the last dose, and a later pharmacogenetic test from another provider: Lexapro was the problem. 

Desired Outcome:

Wilmington Hospital ED and Psych ED personnel should undergo high quality Trauma-Informed Care (TIC) training, such as that offered by the non-profit Zero Abuse Project. This should be implemented as soon as practicable. So long as ChristianaCare and its clinicians remain uninformed and ill equipped, they will needlessly cause additional great harm to countless highly vulnerable people, particularly now, during the fast-rising tide of trauma survivors due to the pandemic.

Frontline Wilmington Hospital staff should be required to take de-escalation training immediately, starting with those who work in the ED/Psych ED. A few quick tips on how to de-escalate situations with upset people would clearly be to everyone’s advantage, particularly the patient who just needs to be treated well. “Treat me well” is a double entendre. 

All staff who interview patients with SI should read and understand the Veterans Association’s “Suicide Risk Assessment Guide,” because clearly Dr. Koczirka didn’t comprehend he should ask “what makes things better and what makes things worse regarding the onset, intensity, duration and frequency of suicidal thoughts and feelings assists the clinician in developing a treatment plan,” or that appropriate crisis intervention techniques “include removing or securing any lethal methods of self-harm, decreasing isolation, decreasing anxiety and agitation, and engaging the individual in a safety plan (crisis management or contingency planning).” 

Also, I request an apology from Dr. Stephen Koczirka for gaslighting and lying to coerce me into agreeing to psychiatric hospitalization, which was unnecessary and deeply harmful.

June 30, 2025:

The hospital’s response was unacceptable. As far as I can tell, no significant changes were made. It’s still “standard treatment” for all! I will keep talking about it until enough people hear to MAKE. IT. STOP.