Examining Alaska’s Mental Health Care Failures May Benefit
May is Mental Health Awareness Month. There are good reasons to celebrate the advancements in mental health care in Alaska. In my opinion, there are more reasons to look at failures. Top of the list: Alaska does not provide adequate protection for psychiatric patients with disabilities facing unnecessary trauma.
Alaska cannot make headway in mental health care and provide protection for patients when the Department of Health and Human Services does not know statewide how many psychiatric patients file complaints, how many are injured during treatment or transport, or how many face unnecessary traumatic events. Currently, state-level mental health policy makers, including the legislature, are not listening to the voices of psychiatric patients through exit polls or statistics.
Since the state’s inception, Alaska has embraced the easiest way to care for psychiatric patients with disabilities. The Department of Health and Human Services delegates state power to detain and treat psychiatric patients to about 40 private psychiatric facilities or units, and private hospitals set the level of care. It’s convenient for the state, but not good for someone losing their rights in a locked private mental institution.
Psychiatric patients have the right under state law, AS 47.30.847, to lodge a complaint and bring it before an impartial body. Patients are generally not informed that they have these rights. There is no requirement for the training the patient advocate must have in hospital policies. On April 20, Legislative Legal Services issued the opinion that patients have the right to file a complaint, but there is no state enforcement mechanism.
What does it mean for the Psychiatric Patient Grievances Act not to have a state enforcement mechanism? This means that managers of psychiatric facilities or units can choose when a psychiatric patient can use his or her right to file a grievance and bring it before an impartial body or to appeal.
People with 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-down mental institution, most patients are pretty much on their own and are left with a standard of care that, for the most part, has been designed for the convenience of a hospital. .
In 2003, while I was preparing supper, Anchorage police came to my home and said they had been ordered to take me to the Alaska Psychiatric Institute for a psychiatric evaluation. I was handcuffed. I asked the police if they would receive my jacket, shoes, keys and glasses. The police refused my request. I was kicked out the door in the winter barefoot and cold without glasses to be transported in a police car marked to the Alaska Psychiatric Institute.
I am nearsighted and without glasses, I am legally blind beyond a foot. I spent five months in API without glasses. The API management kept telling me that they wouldn’t help me get glasses and that I would have to wait until I was released so I could get my own glasses. There are no independent patient advocates in major psychiatric units who are readily available to help patients resolve their complaints during business hours.
Even cooperating psychiatric patients with disabilities are handcuffed and placed in a marked police car during transport to a psychiatric facility or unit. Alaska has not produced a plan on how to transport psychiatric patients and provide care in the best possible way to reduce trauma.
There are tangible benefits for Alaska in moving psychiatric patients with disabilities through a transportation and care system in a way that reduces trauma to the lowest possible level. And there are some very real benefits to the patient on the road to recovery.
Acute care psychiatric patients are one of the most vulnerable and abused groups in Alaska, often alone and frightened. It would be in Alaska’s best interest to provide people with mental illness coping skills free from unnecessary trauma and abuse, as well as rights with an enforcement mechanism and oversight.
Better quality 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 “Going Crazy in Alaska: A History of Alaska’s Treatment of Psychiatric Patients,” and has volunteered as a mental health advocate for over 10 years.