Even after 100 years of positive advancements in psychiatric patient rights and quality of care, more needs to be done. For the most part there is a healthy symbiotic relationship between those seeking or needing medical help and those providing the help.
It is the helpless that do not always fare well in a free marketplace. One of the best examples is individuals with a severe mental illness or dual diagnosis; mental illness along with a myriad of conditions that may decrease mental capacity.
Once a person is determined by society to be incapacitated because of a mental illness, who is to decide what is in their best interest? To an extent, the Alaska Supreme Court answered that question in Myers v. Alaska Psychiatric Institute (2006).
The danger to Alaska psychiatric patients comes about when a patient wants to file a legitimate complaint and “who will decide the merits of that complaint?” As of now, employees of psychiatric institutions and units decide the merits of a patient’s complaint.
In the 2006 decision, the Alaska Supreme Court determined that psychiatric institutions and units tend to operate in self-interest, so much so it presented a clear danger to patients.
If we agree with the Alaska Supreme Court, and we do, then why would we as patient advocates want psychiatric institutions and psychiatric unit employees to be the final authority of a psychiatric patient’s complaint?
Any psychiatric patient in a locked facility or unit in Alaska with a legitimate complaint concerning medical or physical care is in danger for three reasons:
One: There is no formal appeal process with due process for a psychiatric patient’s complaint past the walls of the institutions or units in state law or regulations. An aggrieved patient could call the police or ask a private advocacy organization to assist them in filing a formal appeal in a court, but that generally only happens after severe damage has been done.
Two: Current law AS 47.30.847 states there must be an impartial body to hear a psychiatric patient’s complaint, but it does not say who the impartial body must be. Most executives of psychiatric institutions and units have stated their own employees will act as the impartial body. The Alaska Supreme Court in a 2006 ruling indicated that psychiatric hospitals’ employees are not impartial.
Three: There are presently insufficient detailed rules concerning due process for a psychiatric patient’s complaint or appeals in law or state regulations to protect patients.
There is no inexpensive way to make necessary changes to psychiatric patient rights and care. Improving psychiatric patient rights is always going to be expensive; $100, 000 on up to pass a new law, especially when most large providers of psychiatric services will oppose any improvements in psychiatric patient rights, even necessary ones.
Two examples: The states of Maine and Georgia took the less desirable route to improving their grievance procedure and appeal process for psychiatric patients. They simply waited until enough patients died or were abused while institutionalized and the states were taken to court and they lost. Putting aside the human tragedy, it cost the two states multi-millions of dollars to fix their patient grievance procedures.
The current Alaska grievance procedure law AS47.30.847 and associated rules do not properly protect psychiatric patients and their family members in the grievance/appeal process and they need to be legislatively revised and updated. The passage of Senate Bill 55 will improve a patient’s right to file a grievance or appeal.
• Myers and Collins are Mental Health Advocates based in Anchorage.