Legislature must act to protect psychiatric patients

In 1962, working in close cooperation with the Federal Public Health Service, the Alaska Legislature passed an Enabling Act creating an in-state Mental Health Care System. Typical of 60 years ago, there was little or no consideration for adding the key components to patient recovery: psychiatric patient rights.

In the months I spent locked in psychiatric facilities in Alaska, 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 more than 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 my 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.

In my experience, the effects of the unnecessary trauma patients face during treatment is costing the state of Alaska millions of dollars: 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 reliving 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.

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. There is little to 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. Sixty years late but still necessary, there must be a legislative solution by adding protective rights for 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.”

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