Modest legislative improvements in disabled psychiatric patient rights like improving the grievance procedure law and appeal process would save lives. About 40 percent or more of the individuals provided forced psychiatric treatment will be damaged by their treatment; even modest improvements in quality of patient care, such as recognizing and treating sanctuary trauma, would significantly lower that number.
Until the general public and the Legislature has an understanding of the types of patient complaints in locked psychiatric institutions there will be no necessary improvements. Today there is no impartial body to pass judgment on a psychiatric patients’ grievance or formal appeal, only hospital employees who at too many times have a reason to keep secrets.
Forced psychiatric evaluation and forced treatment is often a physical process. Thousands of individuals go through forced treatment or evaluation each year in Alaska. There is a real potential of a patient arriving at an acute care psychiatric unit in handcuffs, being strapped to a gurney or placed in isolation, degrading conditions that often leads to lack of self-worth. The amount of power given to the managers of private psychiatric units to detain an individual has never been matched with state laws designed to allow the individuals being detained to protect themselves from mistreatment.
When compared to other states, Alaska is very unique. The Department of Health and Social Services turns disabled psychiatric patients over to the staff of locked private psychiatric facilities with very few specific standards of care and protections (47.30.660 (b) (13)). Two state attorneys have said there is an argument that Alaska’s unique way of delegating care of disabled psychiatric patient as probably unconstitutional.
Statistically, by the time a person ends up in a locked acute care psychiatric facility, they have burned many of their bridges with family and friends. That leaves a patient’s primary caregiver and protector to employees of a psychiatric institution. The patient advocates work for the hospitals with no autonomy and the hospitals write the patient grievance procedure and appeal process. Ninety-eight percent of legitimate patient complaints will never leave the psychiatric hospital to be viewed by the general public or the Legislature.
Individuals in Alaska with a severe mental illness are mistreated. What is not obvious to the general public or the Legislature is the extent of the mistreatment. In 2005, at state-run Alaska Psychiatric Institute, the three sexual abuse allegations by patients were discounted. Fifty-four complaints of not receiving respect or dignity were discounted. Multiple complaints of physical abuse were discounted. Eighteen complaints of not being safe were discounted. The power of discounting patient complaints even today goes in favor of the managers of psychiatric institutions. API management in 2005 was embarrassed. API’s answer: Never again let the general public look at the specific categories of patient complaints in their hospital.
There is no vaccination or preparatory lesson to prevent a person from developing a mental illness. I have an associate’s degree in Early Childhood Development, never smoked, rarely drink alcohol, but still developed a severe mental illness. Because of poor institutional treatment, I had to be treated for post-traumatic stress injury, costing hundreds of hours in treatment and thousands of dollars. The psychiatric institutions working to stabilize my mental illness with medications often valued convenience and economics above quality of care and patient rights.
A female with a severe mental illness is the most likely to be sexually or physically assaulted, or be taken advantage of. A female in an acute care psychiatric unit has a better than even chance of developing or exacerbating some form of post-traumatic stress injury. Improving rights for psychiatric patients would cut down on suicide, recidivism, assaults and PTSI. Today management of psychiatric units and their employee unions are the major roadblocks to the state making necessary improvements to psychiatric patient rights and quality of care.
Caring for disabled psychiatric patients or individuals with a dual diagnosis has become a multi-billion-dollar business and “Alaska’s latest gold rush.” Practically every major healthcare corporation wants in. In the absence of strict state standards, the decision of quality of patient care for the disabled is often decided in a boardroom 2000 miles away. The state of Alaska and the Legislature should be setting the grievance and appeal rights and due process — how a patient is informed of their rights — and a dozen other quality of care issues. Acute care psychiatric patients with some evidence believe they have been sold to the lowest bidder.
• Faith Myers and Dorrance Collins are mental health advocates who live in Anchorage.
