Thousands of people each year in Alaska are transported to a locked psychiatric facility or unit for forced psychiatric evaluations or treatment. Very few people will receive the treatment that is needed to provide the best opportunity to recover and rejoin society. I put the blame for the poor standards of psychiatric patient care squarely at the feet of the Alaska State Legislature and the governor.
House Bill 80 and its companion, Senate Bill 53, gives the option to prosecutors to more easily civilly commit people who are accused of committing a violent crime but are unable to stand trial because of a mental illness as a way to get them off the streets. The House and the Senate have not answered the question of how they are going to place violent people in psychiatric units and protect the non-violent patients. The way I see it, there is no reasonable plan in the bills to protect non-violent patients from violent patients.
The state has a long history of not providing proper protection and care for people the state considers to have a disability and are locked in psychiatric institutions. In 2021, the state Ombudsman in a report stated that only about half of the patients at the state-run Alaska Psychiatric Institute were given an individualized treatment plan. What that translates to is that at least one half of the patients were simply warehoused and not given a reasonable opportunity for recovery. An individualized treatment plan would also give staff a blueprint on how to properly care for people with trauma in their background.
The state Ombudsman also stated in a report that it appears that staff at API has a permissive attitude towards patient-on-patient assaults. When more violent and unpredictable people who have committed crimes are placed in API as patients because of the passage of HB 80 or SB53, it will present an unnecessary danger to non-violent patients. When I was a patient in API in 2003, a fellow patient had a habit of putting bars of soap in a sock and going around swinging it. He was looking for any patient to threaten. In my observation staff would not step in until someone was injured.
In 2017 at API, there were 116 patients injured, 90 needed hospitalization or medical care. Fifty were the result of patient-on-patient assaults. There has never been an effort by the state to document and publicize patient complaints, injuries and traumatic events from all psychiatric facilities and units financially supported by the state. People with a mental illness appear to be a forgotten and unprotected class in Alaska.
It was reported in a newspaper that the police were called to the North Star Behavioral Health Services about 100 times in 2022, either to arrest patients for violent actions or to investigate destruction of property. No non-violent psychiatric patient should be required to receive treatment in a facility that is known for violence.
The state of Alaska delegates much of its responsibility of caring for and protecting acute care psychiatric patients to managers of psychiatric facilities and units. The state legislature and others have done very little to set a standard of care and patient protection. Even the writing of the psychiatric patient grievance rules is controlled by the managers of psychiatric institutions.
The standard treatment of acute care psychiatric patients in facilities like API promotes a revolving door commitment of patients or leaves them sleeping on the streets. Patients are often cut off from family, friends and the community; unable to go outdoors in the fenced in courtyard on a regular basis; and as stated in a previous paragraph, unable to fully participate in their treatment plan.
House Bill 80 and Senate Bill 53 must have more ambition than simply getting dangerous people off the streets. There must be rules in the bills to better protect non-violent patients from violent patients in psychiatric facilities and promote better rights for all psychiatric patients.
• Faith J. Myers is the author of the book, “Going Crazy in Alaska: A history of Alaska’s treatment of psychiatric patients,” and has spent over 7 months locked in psychiatric facilities in Alaska. Columns, My Turns and Letters to the Editor represent the view of the author, not the view of the Juneau Empire. Have something to say? Here’s how to submit a My Turn or letter.