By Faith J. Myers
In the months I spent locked in psychiatric facilities, I lived alongside hundreds of psychiatric patients. Some I remember quite fondly, and others with a touch of sadness. In the best of times, being locked in a psychiatric institution is humiliating. Some walk away from the experience in one piece, others don’t. One significant obstacle to ensuring adequate patient care is the absence of a viable independent process for patient grievances.
For the last 20 years, the state-run Alaska Psychiatric Institute has reduced its obligations and capacity: In 2020, staff at API conducted forced evaluations or provided treatment for 660 people. As of today, well over 90% of the acute care psychiatric patients in Alaska are evaluated or treated in locked, private psychiatric facilities or units outside of API.
What happens to a person that is undergoing a forced psychiatric evaluation or treatment in a private facility remains a well-kept secret from the general public and the legislature. The Department of Health and Social Services is not required to keep statistics of psychiatric patient complaints and injuries, or traumatic events experienced by patients even in the facilities financially supported by the state.
The State Ombudsman’s Office released the following statements in a report on March 18, 2019:
“Based upon a preponderance of the evidence, the Ombudsman finds the allegation that API does not reasonably protect patients from excessive or unnecessary use of force by staff to be justified.
“The ombudsman investigation determined that API had not reported the assault of the patient to law enforcement as required by API policy and procedures.
“The Ombudsman is also concerned that some staff display a permissive attitude toward patient-on-patient assaults.” As a note: In 2017, 116 patients at API were injured, 50 were the results of patient-on-patient violence.”
As a psychiatric patient advocate, I have seen no changes in psychiatric patient laws or regulations over the last 3 years that would require API to treat patients in a better fashion. And the fact that there are very few on-site state investigations of patient mistreatment in private facilities and no state effort to keep statistics of patient complaints and injuries or traumatic events is alarming.
The past efforts of psychiatric patient advocates to improve patient rights and care has often been countered by hospital employee unions and psychiatric hospitals that wanted to see no improvements in patient rights. Improvements in patient rights would add a level of accountability to hospital staff and management.
In my experience, the effects of the unnecessary trauma patients face during treatment is costing the state of Alaska millions: physical takedowns, being strapped to a gurney, being placed in isolation rooms and a loss of rights and freedoms. Sexual and physical abuse victims in locked psychiatric hospitals often end up re-living many of their past traumas. As of now acute care psychiatric patients in Alaska too often endure unnecessary damaging hospital policies with no effective way to complain to an impartial body.
In a letter dated Aug. 22, 2013, the commissioner of the Department of Health and Social Services stated that psychiatric patients locked in a psychiatric facility do not have a right by state law to appeal the resolution of their complaint to hospital management or to a state agency. The letter also stated that patients could bring an appeal of mistreatment to the courts, but in my opinion, patients do not have the financial resources and if they did and lost the case, they could be required to pay attorney’s fees to the State.
Many of the state laws claiming to protect disabled psychiatric patients were given no enforcement mechanism and do little or nothing to protect patients. For more than 20 years the Alaska government has depended heavily on Medicaid/ Medicare and the hospital certification organization, the Joint Commission, to protect psychiatric patients, i.e., setting the patient grievance standards, etc. There is little or no independent or state presence in protecting disabled psychiatric patients inside locked private institutions from mistreatment or unnecessary trauma.
Locked private psychiatric hospitals and units should be a sanctuary and a place for healing for people that develop a mental illness. There is no good reason for hospitals to keep secret from the Legislature and the public the number and type of patient complaints or injuries or the number and type of traumatic events patients face in private facilities. There must be a legislative solution to protect psychiatric patients in 2022.
• Faith J. Myers is the author of the book, “Going Crazy in Alaska: A History of Alaska’s Treatment of Psychiatric Patients.” 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.
