OPINION: Alaska’s inadequate psychiatric patient rights hinder recovery

Most organizations and individuals concentrate on improving psychiatric patient rights at the state-owned Alaska Psychiatric Institute. According to my assessment, more than 90% of the acute care psychiatric patients in Alaska that undergo a forced evaluation or treatment do so outside of API. The state may have a different opinion, except they don’t publicize their statistics.

There are psychiatric facilities and units in Alaska that receive direct state funding. Some examples are Providence Hospital’s Psychiatric Emergency Room, Fairbanks Memorial Hospital, Bartlett Regional in Juneau, etc. They operate with many of the powers and duties of the state. There are a dozen or more other locations that receive state grant money to care for people with disabilities. These facilities operate with an insufficient state standard of care and oversight. And they operate in secret because they do not share statistics of psychiatric patient complaints, injuries and traumatic events experienced by psychiatric patients.

I read a booklet outlining psychiatric patient rights. It stated that if a patient wanted to file a grievance, they should just contact their provider. Many states offer independent assistance when patients file a grievance. Alaska does not. As a way to distract patients, patients with a complaint are often sent to Joint Commission, Office of Licensing, Medicaid/Medicare. These organizations work on systems, not individual patient complaints.

In 2004, I served on a one-day committee that was looking at needed improvements in psychiatric patient rights at API. The committee was dominated by state workers. Not a single needed improvement in psychiatric patient rights and care was adopted by API.

In 2005, I was on a committee that was looking at needed improvements in the grievance rights for psychiatric patients at API. Staff from the following organizations were on the committee: API staff, Disability Law Center, Alaska Mental Health Board and API Advisory Board.

The majority vote of the committee was that psychiatric patients should have a right to file a grievance at the time of their choosing. API staff wanted to have the right to choose when or if patients could file a grievance as a way to do away with what they considered frivolous grievances. In the end, API management made the point that they have the right by state law to produce their grievance procedure anyway they want. And they do.

What are the grievances API management can do away with or downplay so the complaints get little or no investigation? Some examples: patient-on-patient assaults; in 2018 a woman was sexually assaulted at API and was left to sit half-naked; not receiving individualized treatment plans; and staff-on-patient assaults.

The Department of Health and the Department of Family and Community Services have not seen a loophole that they did not want or utilize to deny psychiatric patients the fair rights that they have been given. As an example: In 1992, psychiatric patients were given a right by state law AS 47.30.847 to bring their grievance to an impartial body. To my knowledge, patients have not been told they have that right. Nor how to bring their grievance to an impartial body. And if at some point patients are told that there is an impartial body available, it would be so far out in time, it would not actually help patients.

There are also problems with the gender choice of staff by patients for intimate care law, AS 18.29.095. It is not strictly followed by API and other facilities. AS 47.30.840, the 11 rights of psychiatric patients, gives too much leeway to hospital managers to decide the level of patient rights with no state oversight.

In my estimation, there are approximately 10,000 people that rotate in and out of locked psychiatric facilities or units for a forced evaluation or treatment outside of API each year. That includes people that are sent out of state.

The heavy concentration on patient rights at API alone is not sufficient. All acute care psychiatric patients considered to have a disability because of a mental illness should be protected by the state, regardless of the facility they have been locked in. The state must be involved in setting a standard of care and protections.

Faith J. Myers is the author of the book, “Going Crazy in Alaska: A History of Alaska’s treatment of psychiatric patients,” and has spent more than seven months locked in psychiatric facilities in Alaska.

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