Kim Kovol, commissioner of the state Department of Family and Community Services, wrote a Nov. 18 opinion piece praising the staff at the state-run Alaska Psychiatric Institute. I also commend the API staff for doing a difficult job, but there is more to the story.
It is a bold statement to say: “All the patients in locked psychiatric facilities or units are mistreated.” But I can make that claim with a high degree of certainty for two reasons. One — I have taken the time to read the history of mental health care in Alaska and two — I have spent over seven months as a patient in locked psychiatric facilities, mostly in API.
The Alaska Psychiatric Institute is operated by the Department of Family and Community Services, and Kim Kovol as commissioner plays a major role in setting the direction of API’s operations and policies. It was stated that API has cut down on patient-on-staff assaults, but there was no mention of patient-on-patient assaults or staff-on-patient assaults.
Psychiatric patients in locked facilities like API are mistreated — not necessarily because of the staff, because the staff at a psychiatric hospital are made up of a cross-section of a community, some good, some bad. Patients in locked psychiatric facilities are mistreated because they do not have good protection laws and the protections laws they do have do not have a state enforcement mechanism.
Alaska has a 124-year history of sending people to locked psychiatric facilities. During most of that time it was considered a crime for a person to develop a mental illness and become a burden for the state. Treating psychiatric patients as criminals has become a habit the state has found difficult to erase. Alaska psychiatric hospitals too often operate for convenience and economics, and too often patient rights are removed.
In 2008, Senate Bill 8 became state law AS18.20.095. Among other things, the law requires that routine safety checks into a patient’s bedroom, bathroom, or shower must be done by the same gender staff as the patient to cut down on patient trauma. In support of the bill passing, Disability Law Center produced several pages of legal opinion of why psychiatric patients had a right by state and federal law to privacy. Even today, API has not written hospital policies that require them to faithfully follow the gender choice law.
Patients in some locked psychiatric facilities have a right by the state psychiatric patient grievance law AS47.30.847 to have access to a trained patient advocate. Psychiatric facilities like API might mention a patient advocate in their policy, but patients are not specifically told they have a right to have access to a trained patient advocate.
Psychiatric patients in locked facilities also have a right by state law AS47.30.847 to bring a grievance to an impartial body. The Legislature made a mistake by not adding any rules to the law. And psychiatric facilities get to decide what the impartial body looks like and what patients in facilities like API must do to actually reach the impartial body with their grievances. Over the last 32 years patients at places like API had a better chance of finding a unicorn than they did of finding the impartial body.
According to API statistics, in 2005, 2017 and in 2022 no patient brought their grievance to an impartial body. In my opinion, patients were not able to do so because they were not given a reasonable opportunity to bring a grievance to an impartial body.
By state law AS47.30.840 psychiatric patients in locked facilities are given eleven rights. Giving rights and accompanying hospital policies to patients costs money. API and other psychiatric facilities for decades have been reluctant to write clear policies that would guarantee psychiatric patient rights and there is no state enforcement.
It is not just the staff that makes a psychiatric hospital a good place for patients to recover. It also comes down to good state laws and hospital policies. That is what helps patients recover. And as of now, Alaska is failing. The Legislature needs to step in and update psychiatric patient laws and protections.
• Faith J. Myers, a psychiatric patient rights activist living in Anchorage, is the author of the book, “Going Crazy in Alaska: a history of Alaska’s treatment of psychiatric patients,” and has spent more than seven months as a patient in locked psychiatric facilities in Alaska.
