OPINION: Asking questions is vital to improving Alaska mental health care

The Alaska Mental Health Trust Authority on Sept. 12 held a listening session for Trust beneficiaries. There are approximately 10,000 Trust beneficiaries who rotate in and out of locked psychiatric facilities or units each year for a forced psychiatric evaluation or treatment. It is important that the state continues to seek information on how to improve psychiatric patient care from the patients.

A lot of credit goes to state officials, from the Department of Health and its Behavioral Health division, including the Mental Health Trust staff, for listening to testimonies from Trust beneficiaries. Psychiatric patients with lived experience through direct testimonies can provide vital information on how to improve care. But often because of disabilities, the only voice psychiatric patients have is statistics.

About 15 years ago, the staff at the Alaska Psychiatric Institute conducted a patient survey. The question that was asked of patients: “Do you feel safe filing a complaint?” Twenty-one percent of the patients surveyed said, “no.” Nineteen percent did not answer the question. A reasonable person would say that as many as 40% of the patients at that time were afraid to file a complaint. The fear of filing a complaint stems from the fact that patients have to talk to hospital staff, and many patients do not feel safe complaining.

Psychiatric facilities and their health care workers have a state mandatory requirement to report when psychiatric patients are being mistreated. As an example, when a patient is sexually assaulted or injured by another patient or a staff member, those reports go to Adult Protective and Child Protective Services. The mistake the state is making: Those reports are kept secret from the general public, the Legislature and the media. How can the state be motivated to make improvements when it keeps secrets?

Alaska has a history of understating the level of disability of people who wind up as patients in locked psychiatric facilities or units. Letting the public know the severe level of the disability of patients would require the state to provide patients with more protections and assistance in the protection of their rights. Patients in API range from having an intellectual or developmental disability along with mental illness or are undergoing a psychotic break where they lose complete touch with reality.

In 2023, the Legislature received a lengthy report on which they spent about a quarter-million dollars, regarding how to improve psychiatric patient rights and care. There were many good suggestions in the report. One of the recommendations was for the state to find a way to keep and share statistics of psychiatric patients’ complaints, injuries and traumatic events that happen in locked facilities. To my knowledge, not a single recommendation in the report has been acted upon by the Legislature.

Providing adequate protection for people in locked psychiatric facilities would cost the state money. It would also be an added cost for the state to require psychiatric facilities to keep statistics of psychiatric patient complaints, injuries and traumatic events and share them with the Legislature and the general public. But doing so would greatly increase the quality of psychiatric patient care and protections.

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

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