Want better care at API? Respect and improve rights of patients

We read the commentary by Charles Wohlforth, Jan. 15, "Here's what drove the former head of API to quit; 18 months later, the problems aren't fixed."

We know for a fact that it will take more than increasing security, staff, psychiatrists and bed space at Alaska Psychiatric Institute to bring Alaska into the 21st century concerning improved patient care; the disabled need improved rights. That point was missing from Wohlforth's commentary. Our position has always been improving rights for the disabled will force the state of Alaska to do the right thing concerning psychiatric patient care.

Alaska's long-term plan to care for the disabled, especially acute-care psychiatric patients, is broken. A better way to put it is it has never been fixed. As an example of evidence, the increases in suicide, alcohol and drug addiction, homelessness and the unrecognized cases of post-traumatic stress disorder because of poor treatment in institutions. History tells us that until there are real improvements in the rights for the disabled in Alaska, the system will remain broken.

[API is an unsafe workplace, investigators say. This caregiver suffered the consequences.]

Harborview Memorial Hospital, a facility for individuals with cognitive and developmental disabilities, opened its doors in Valdez in 1961 and is now closed; clients have moved on to community programs. Individuals with a cognitive and developmental disability in Alaska have never been given the right by state law to file a formal grievance and an appeal specifically designed for their disabilities with their provider or a state agency. That puts Alaska 20 years behind in best practices.

Alaska Psychiatric Institute opened its doors in 1962 and filled 225 beds by 1965.  Morningside Hospital in Oregon closed its doors in 1971. Some of the disabled Alaska residents were transferred back to Alaska, others to other hospitals in Oregon. At the time, none of the disabled psychiatric patients had a right by Alaska state law to file a formal grievance or an appeal within a facility or to a state agency. That put Alaska 20 years behind best practices.

In 1981, the state attorney general stated (paraphrasing) that the rights for psychiatric patients needed to be improved to protect hospitals from lawsuits.  The Legislature did just that — the Legislature improved the rights for psychiatric patients just to the point to protect hospitals from lawsuits, but not adequate to protect psychiatric patients or the disabled in general. State law AS47.30.847 simply tells psychiatric facilities and by extension their certification organizations to produce a grievance and appeal process for psychiatric patients. Turning the writing of the patient grievance and appeal process over to psychiatric facilities puts Alaska 30 years behind in best practices.

A state planning committee in 1992 advocated for a smaller state-run Alaska Psychiatric Institute. In 2005 the new API hospital opened its doors with less floor space for patients. The necessary treatment mall and the patient library were removed from the hospital design to save money. The new hospital practices a cookie cutter assembly line treatment where acute-care patients are held on average of 5 days, then sent out the door. That puts Alaska 20 years behind best practices.

The individuals who are brought to API for treatment are 90 percent involuntary and considered mentally disabled by the state and often needing physical care. Best practice would be to provide patients dental care, a new set of clothes, haircuts, personal grooming help and access to a treatment mall for socialization. To promote recovery, something has to physically change for a patient besides just adding medication. None of that is consistently happening now for patients at API. A poorly designed and run API  hospital puts Alaska 20 ears behind best practices.

[Alaska's undersized state mental hospital puts patients and public at risk]

The Alaska government has created the perfect storm to mistreat the disabled.  The disabled are asked to join society but then not given the rights they need to protect themselves and feel included. Fifty years ago the state of Alaska simply locked up many of the disabled for long periods of time — now most are set free but without the needed rights to join society.

The Alaska government has never made the connection between lack of rights for the disabled and the increase in suicides, alcohol and drug addiction cases and homelessness. But we as advocates have and so have many other states that now work to provide best treatment and care for their disabled. Alaska should adopt best treatment and care practices for the disabled by improving the rights for the disabled. As a beginning to improving rights, hold a fact-finding state Senate hearing.

Faith Myers has an associate's degree in early childhood development. With the help of attorney James Gottstein, she prevailed in a Supreme Court case "Myers v API."  She has served on numerous Alaska Psychiatric Institute patient care improvement committees and has served for 10 years as a board member of Assets, Inc.  Dorrance Collins came to Alaska in the early 70s and worked a variety of jobs from Ketchikan to Adak.  Both have worked as mental health advocates. They live in Anchorage.

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