Opinion: Alaska’s mental health care hospitals must produce a report card

In 2025, the Alaska Legislature will appropriate tens of millions of dollars for the care of people with an acute mental illness. Without at least an annual report card outlining patient satisfaction and recovery rates, the Legislature and the general public will have no way of knowing if the mental health programs in locked facilities are helping or hurting patients.

On Dec. 19, with the help of celebrity Paris Hilton, The Stop Institutional Child Abuse Act gained overwhelming bipartisan support in the U.S. House after passing the Senate unanimously. The bill has now been signed into law by President Joe Biden.

Hilton testified that as a teenager, she was locked in four different psychiatric facilities for what she described as behavioral issues. Here are some of the complaints that she told to Congress: She was required to undress and shower in front of male staff, she was cut off from family, she wasn’t able to hold private conversations on the phone and any breaking of hospital rules could result in what could be described as “corporal punishment.” She described psychiatric facilities heavily dependent on medication and not talk therapy.

The same abusive conditions in psychiatric facilities that Congress found appalling are happening in Alaska and for the same reasons: insufficient state oversight and, for the most part, psychiatric facilities are allowed to operate in secret from the public and the Legislature.

For Alaska to have a successful mental health care system for people with acute mental illness, we need to know the number of people that rotate in and out of locked psychiatric facilities each year for a forced evaluation or treatment. We also need to know the number and type of psychiatric patient complaints, injuries and traumatic events during treatment or transportation. Only through legislation can there be a requirement for the state to keep and share these statistics.

Such statistics are often the only voice patients in locked psychiatric facilities have. As an example: if there are 50 patient-on-patient assaults at a facility, that would tell the state that there needs to be a separation of violent patients from non-violent patients. If the police are called to psychiatric facilities over 100 times in a year to subdue violent patients, those statistics would tell the state that forensic units need to be larger with sufficient staff. As of now, state agencies are underestimating the importance of statistics in helping to shape a good mental health care system.

In 2023, House Bill 172 increased access to behavioral health crisis services in less restrictive settings by adding an intermediate, sub-acute level of care, which allows individuals in behavioral health crisis to divert from institutional settings. But without the state making statistics available to the public, there will be no way to make improvements in patient care and rights.

Every state has a Disability Law Center that provides assistance for people with a disability. Many states also have an Office of Advocacy at the state level or an independent office contracted by the state to protect people with disabilities. One of the good points of these offices is that they are not only required to protect people with disabilities, but also required to advance patient rights. The Alaska Legislature should create an Office of Advocacy.

Paris Hilton was right. Psychiatric institutions should be required to be more forthcoming with statistics. And psychiatric patient rights need a state enforcement mechanism. It is up to the Alaska Legislature to make that happen.

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 as a patient in locked psychiatric facilities in Alaska.

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