In the last 50 years there has not been a comprehensive, fair conversation about the ability of state-run Alaska Psychiatric Institute to care for psychiatric patients in a way that promotes recovery and safety for the patients and staff.
A recent news article quoted a report that the Department of Labor in November 2017 fined API $44,000 for being an unsafe workplace. Before the fine numerous API staff were injured by patients. There is more to that story. When the new API building opened, the Head Nurse with over 20 years of experience stated the only unit out of five properly designed at API was the adolescent unit. Today, because of less separation between male and female patients in the new hospital, female Psychiatric Nurse Assistants (PNA’s) now come in more contact with male patients, all due to poor hospital design.
The new API hospital has less floor space for patients than the old hospital. That raises the aggression level of patients and hinders recovery and puts everyone at risk. Numerous rooms in the new hospital meant to be open to patients do not have line of sight to staff, so they are permanently locked, further reducing floor space to patients.
The employee’s Union at API wants to protect staff but they do not mention that they opposed a law that would give gender choice of staff for intimate care to patients (bathing, personal care, etc.) — the law passed anyway reducing stress to patients. The Union also does not mention that they opposed improving the patient grievance procedure law to best practice — a poor grievance procedure raises the frustration level of patients.
Staff at API are opposing a policy to recognize and treat institutional trauma to patients which can cause Post Traumatic Stress Disorder. Hospital staff also opposed, since 2003, updating and making readily available hospital patient policies to guardians and hospital patients. As an example — when can patients go outdoors? — when can patients use the phone? These are rights given by law and most often taken away from psychiatric patients for minor infractions of hospital rules.
In 1981, the state attorney general stated (paraphrasing) that the rights for psychiatric patients needed to be improved to protect hospitals from lawsuits. The Legislature did just that—the Legislature improved the rights for psychiatric patients just to the point to protect hospitals from lawsuits, but not adequate to protect psychiatric patients or the disabled in general.
Psychiatric hospitals and units when treating patients now operate in self-interest, economics, and convenience, so much so the Alaska Supreme Court made a note of that in one of their decisions when ruling against state-run API (Myers v. API). Given the right legislative pressure, state agencies, like the Department of Health and Social Services, will realize that patient recovery and safety should be paramount to convenience.
It is important to protect the staff at state-run Alaska Psychiatric Institute. But to have a real comprehensive, fair conversation as a state we have to include patient needs in the conversation: their protection, their recovery, their need for improved rights under law.
• Faith Myers and Dorrance Collins are mental health advocates. They reside in Anchorage.
