May is Mental Health Awareness Month. There are good reasons to celebrate the advances in mental health care in Alaska. In my opinion, there are more reasons to examine the failures. At the top of the list: Alaska is not providing adequate protection for disabled psychiatric patients facing unnecessary trauma.
Alaska cannot make advances in mental health care and provide protection for patients when the Department of Health and Social Services does not know statewide how many psychiatric patients file a complaint, how many are injured during treatment or transportation, or how many face unnecessary traumatic events. As of now, mental health policy makers at a state level, including the Legislature, are not listening to the voices of psychiatric patients through exit polls or statistics.
Ever since statehood, Alaska has taken the easy way of caring for disabled psychiatric patients. The Department of Health and Social Services delegates to approximately 40 private psychiatric facilities or units the authority of the state to detain and treat psychiatric patients and the private hospitals set the standard of care. This is convenient for the state, but not good for a person losing their rights in a locked private psychiatric facility.
Psychiatric patients have a right by state law, AS 47.30.847, to file a grievance and bring it to an impartial body. Patients are not generally told they have those rights. There are no requirements of what training the patient advocate must have in hospital policies. The Legislative Legal Services, on April 20, put forth the opinion that patients do have a right to file a grievance, but there is no state enforcement mechanism.
What does it mean for the psychiatric patient grievance law not to have a state enforcement mechanism? It means that managers of psychiatric facilities or units can choose when a psychiatric patient can use their right to file a grievance and bring it to an impartial body or file an appeal.
People with a severe mental illness tend to burn bridges with family and friends. And by the time a person is dropped off or transported to a locked psychiatric facility, most patients are pretty much alone and find themselves facing a standard of care that for the most part has been designed for a hospital’s convenience.
In 2003, while I was cooking supper, the Anchorage police came to my apartment and stated they had an order to take me to the Alaska Psychiatric Institute for a psychiatric evaluation. I was placed in handcuffs. I asked the police if they would get my jacket, shoes, keys and glasses. The police refused my request. I was hustled out the door in winter, barefoot and cold without glasses to be transported in a marked police car to Alaska Psychiatric Institute.
I am nearsighted, and without glasses, I am legally blind beyond one foot. I spent five months in API without glasses. API management kept telling me they would not help me get glasses, and that I would have to wait until I was released and then I could get my own glasses. There are no independent patient advocates inside the major psychiatric units that are readily available to help patients with their complaints during the hours of operation.
Even disabled psychiatric patients who are cooperative are handcuffed and placed in a marked police car during transportation to a psychiatric facility or unit. Alaska has not produced a plan on how to transport psychiatric patients and provide care in the best manner possible to reduce trauma.
There are tangible benefits for Alaska to move disabled psychiatric patients through a system of transportation and care in a way that reduces trauma to the lowest possible amount. And there are very real benefits to the patient in the way of recovery.
Acute care psychiatric patients are one of the most vulnerable and mistreated groups in Alaska, often alone and afraid. It would be in Alaska’s best interest to provide people with a mental illness coping skills free from unnecessary trauma and mistreatment, and rights with an enforcement mechanism and oversight.
An improved standard of psychiatric patient care can only start with legislative action. Mental Health Awareness month would be a good time to start.
Faith J. Myers is the author of the book, “Going Crazy in Alaska: A History of Alaska’s Treatment of Psychiatric Patients,” and has volunteered as a mental health advocate for more than 10 years.
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