NEW article about abuses at Santorum-linked company

In yesterday's Huffington Post, a NEW article about abuses at Universal Health Services (UHS), (US' largest chain of behavioral health hospitals, schools, residential programs, etc. GOP Presidential candidate Rick Santorum sat on UHS' Board of Directors for several years, but doesn't seem to have noticed the constant investigations and allegations...

Santorum sat on Board of Directors of highly-abusive hospital chain.

Still working on a supplemental, fact-filled (and damning) collection of information supplementing my recent radio talk show. Stay Tuned!!!

In the meantime, in light of the Iowa results, new attention being paid to Rick Santorum's longtime membership on the Board of Directors of Universal Health Systems (UHS), the nation's largest operator of inpatient psych facilities, youth residential homes, and juvenile detention facilities - over 200 facilities in total. UHS has a very, very long and extraordinary record of violations of patients' rights at psych facilities - including their facilties here in Massachusetts, and all across the country. Currently, there are several US Dept. of Justice investigations into UHS for rights abuses. UHS employees have given lavishly to Santorum's campaign.

Recently reposted on the Huffington Post:

Rick Santorum And Universal Health Services: Presidential Hopeful Serves On Board of Hospital Chain Being Sued By DOJ

Inside Rick Santorum-Linked Universal Health Services Facility: Herpes, Porn and Drug Dealing        

Coming Soon...

Greetings friends and supporters of this cause...

I am proud to announce that after a (too long) hiatus, this blog is back...with a vengeance!

After a successful bill hearing, we are still waiting for our rights legislation to be reported OUT of Committee in the Massachusetts Legislature. (Things move glacially slow). I'm afraid the advance word is that the bill will be compromised in some way, but I remain optimistic.

Anyway, it is clear to me that without grass-roots activism and a more confrontative (but ALWAYS nonviolent) approach is necessary. The hospital industry is stronger than ever, and using its clout to deny a whole population their basic dignity and humanity. It may be very difficult to oppose them, but I and many others know that we must try...

Anyway, I will soon be adding some detailed information that correlates to the recent "Bipolar Nation" radio program I was honored to be a guest on a few weeks ago. Here's a link to that program:

http://www.latalkradio.com/Bipolar.php

(The show is archived and can be heard for FREE, as well as downloaded as an MP3).

State Watch:
Virginia

The Pines in Virginia, a youth behavioral health program, is infamous for systemic rights violations. The following is a recent account of problems at the Pines, which is owned by the hospital conglomerate Universal Health Services, Inc., which runs over 200 facilities across the country, and has a truly dismal reputation nationwide.

Va suspends admissions at youth home
DENA POTTER, Associated Press

Monday, April 25, 2011

RICHMOND, Va. (AP) — The state has suspended admissions and downgraded the license of a Norfolk-based owner of treatment centers for troubled youth after a series of violations that included the mishandling of a sexual abuse complaint, authorities announced Monday.

The Department of Behavioral Health and Developmental Services on Monday issued a provisional license for the three homes operated by The Pines Residential Treatment Center, agency spokeswoman Meghan McGuire said. The department gave the company six months to address staffing, reporting and other concerns.

A message left with The Pines' administrative office was not immediately returned.

The downgrade is a step toward removing a company's license. While it doesn't preclude the company from receiving state Medicaid funding, "a provisional license is a red flag" for private payers or other states that may house children there, McGuire said.

North Carolina officials said last week they were considering pulling 113 residents from the centers after finding the owner did not report a boy's claims that he was inappropriately touched by two residents at one of the centers. An investigation by Virginia department officials determined the center had failed to properly document the incident or to notify the state or the child's parents.

According to the investigation report, the boy claims he was inappropriately touched by two different residents and flashed by a roommate at the Norfolk center. The boy was admitted to the center on Nov. 2. His parents removed him from the home on Jan. 31, days after they were notified.

Renee McCoy, a spokeswoman for the North Carolina Department of Health and Human Services, said Monday the agency was evaluating a number of options, including finding alternative placement for the children. It has suspended sending new youth to the homes.

McGuire said that incident was not the cause for Monday's action, but "the result of ongoing performance issues that must be corrected to ensure safety and effective treatment for the troubled children there."

"Over the past several years, (the department) has encountered significant problems at the Pines' facilities that have required tremendous monitoring time by our licensing and human rights staff," she said. "The licensing office has had continuous concerns surrounding treatment planning, training of staff, and supervision at the Pines."

Since 2006, there have been 152 investigations among the three centers ranging from minor complaints like staff not returning phone calls in a timely manner to more complicated matters such as the North Carolina sexual assault allegation, McGuire said.

The state is freezing admissions to the company's three Hampton Roads-area facilities "until there is evidence of improvement surrounding" the outlined concerns. Those include:

—Making sure there are adequate programs and staffing, especially for juveniles who come to the centers from the courts.

—Hiring qualified staff and getting them required training.

—Reducing staff overtime.

—Adjusting staff ratios to have one staff person for every four residents, or one for every three residents in units that require more intense supervision.

—Clarifying who is in charge of each unit and ensure nurses are available.

—Implementing a plan that ensures all therapists meet licensing qualifications and are supervised, and making sure there is one therapist for every 10 residents.

—Improving the treatment planning process, including better documenting progress.

—Reporting all incidents, including a monthly analysis of incidents.

McGuire said department officials met with the executive team at The Pines on Friday and advised them of what would happen. She said they were cooperative and agreed "without objection" to work on the issues.

"Because residential placement options for troubled children are limited, we want to see this plan succeed and result in an improved environment and better care for children at The Pines," McGuire said, adding that the department will continue "intensely monitoring" the centers.

According to its website, The Pines opened in 1986 to "provide focused intermediate and long-term care" to youth with mental, emotional and behavioral problems. It is licensed to provide care for 424 youth at its three centers in Norfolk and Portsmouth.

Read more: http://www.greenwichtime.com/news/article/APNewsBreak-Va-suspends-admissions-at-youth-home-1351477.php#ixzz1LE3ar72k

And, prison inmates are given fresh air under law...but not psych inpatients!

With the coming of Spring, having grown weary of the cold and staying inside, we reawaken to the benefits of nature. But hundreds of peers in Massachusetts are still forcibly kept indoors, in sterile hospital units and residences. They can only look outside and yearn for fresh air - at thirty hospitals, and at group homes.

In addition to restraint, lack of informed consent and widespread violation of basic rights, denial of the essential healing gift of fresh air is another collective insult we face.

My last mass email on the subject featured a Federal law that guarantees fresh air to livestock.

Now, here are some State regulations regarding prisons:

Commonwealth of Massachusetts – Department of Correction
Regulation 103 DOC 472
INMATE RECREATION AND LEISURE ACTIVITIES

Section 472.02: Inmate Access to Recreational Programs and Leisure Activities

1. General - It is the department's policy to provide inmates within its custody equal access to recreational and leisure time opportunities and equipment, including, when weather permits, outdoor exercise.

3. Program Access for Inmates in a Department Disciplinary or Special Management Unit [i.e., Maximum/Supermax settings] - All inmates in such units shall receive a minimum of one hour per day, five days per week of exercise outside their cells.

So – organic livestock and prison inmates are protected the law. Peers are protected by neither…

PLEASE NOTE: I am not, in any way, suggesting that animals and prison inmates shouldn’t enjoy basic civil rights. Additionally, I regret any possible (but erroneous) implication that prison inmates are in any way ‘animals’ or ‘animalistic.’ Rather, I am illustrating the fact that while animals are seen as ‘less worthy’ of rights - and prison inmates are jailed for “corrective” purposes, they still have MORE rights than us. This begs the question: what does this say about how society sees us? It sends a message that we are seen as “less than,” and less deserving of rights than those society deems worthy of harsh punishment for their actions!

Also, the ‘purpose’ of psychiatric hospitalization is intended to be therapeutic, even despite the reality that it usually isn’t. Neither farms nor prisons are designed with that same intention. So why is a ‘therapeutic’ environment actually becoming more restrictive than ANY other? And what heals better, with no side effects and very little cost, than nature?

As we enjoy the blossoms and fragrances of Spring, let’s think of our peers who are needlessly kept from it, and continue working hard to put an end to this practice!

Organic Livestock regulations protect livestock, but humans?

Damning proof that peers’ human rights are not considered important at many psych. hospitals.

As you read this, keep in mind that, in Massachusetts alone, AT LEAST 800 people at over 30 hospitals, INCLUDING CHILDREN, are not allowed fresh air or outdoor access on inpatient psych. units in Massachusetts.

What have you seen in your state or country?

United States Code of Federal Regulations
Title 7: Agriculture; PART 205—NATIONAL ORGANIC PROGRAM
Subpart C—Organic Production and Handling Requirements

§ 205.239 Livestock living conditions.

(a) The producer of an organic livestock operation must establish and maintain year-round livestock living conditions which accommodate the health and natural behavior of animals, including:

(1) Year-round access for all animals to the outdoors, shade, shelter, exercise areas, fresh air, clean water for drinking, and direct sunlight, suitable to the species, its stage of life, the climate, and the environment…Yards, feeding pads, and feedlots shall be large enough to allow all ruminant livestock occupying the yard, feeding pad, or feedlot to feed simultaneously without crowding… Continuous total confinement of any animal indoors is prohibited.

(4) Shelter designed to allow for:

(i) Natural maintenance, comfort behaviors, and opportunity to exercise.

Jonathan Dosick

From the Mass. State House

Words from last week's State House event, Boston
Greetings readers, I am returning to actively posting on this site. My apologies for a rather silent period - it follows a busy post-bill filing season and adjusting to a new job. But our effort here in Massachusetts is moving ahead! This is a speech I gave, addressing the current civil rights legislation, at a Lobby Day event at the MA State House in Boston a week ago. It's probably the most concise summary of what we are seeking and why. (As you may already know, brevity isn't my strongest suit, but things are getting better!) As always, YOUR voices and YOUR feedback are most welcome, as we move along toward a Spring and Summer of justice. (As soon as Spring starts - snowstorm here tomorrow!)

Enjoy!!

Today, we’re talking a lot about recovery.

Let’s consider a question: Where and how does recovery start? What kind of environment promotes it?

The seeds of recovery must be planted in soil that is rich with humanity and dignity. For many of us, recovery begins in institutional settings – hospital units and/or group homes.

However, the atmosphere in many of these settings sends messages that hinder recovery.

Right now, the only law in Massachusetts protecting our dignity and our humanity at such places is the Five Fundamental Rights law. But it’s not enforced. This law is broken every single day. And what message does that send? That we’re second-class citizens. We don’t deserve civil rights, even if the law says so, and it’s just too expensive to treat us with dignity.

EVERYONE at psychiatric hospitals and group homes must, under law, be allowed these five rights:

1.) The right to make and receive telephone calls, in private;
2.) The right to send and receive unopened and unread mail;
3.) The right to receive visitors of one’s own choosing, in private;
4.) The right to a humane physical and psychological environment, including privacy and dignity in sleeping, reading, bathing and toileting; and
5.) The right to contact an attorney, outpatient therapist, psychiatrist, doctor or clergy member.

But the reality is much different.

Phones are located in hallways or at nurses’ stations, and often shut off for hours. Mail is opened and censored, and visits are restricted to very short periods of time. Visits happen in common areas, people aren’t allowed to contact lawyers, and bathing and toileting activities are observed, sometimes by members of the opposite sex. How can these conditions promote healing of ANY kind?

House Bill 1430/Senate Bill 986 creates a way for rights complaints to be heard by a neutral third party. NOT hospital employees who may lose their jobs for speaking up, and NOT the chronically-understaffed DMH investigations unit. The bill FINALLY gives us due process – a cornerstone of democracy and fairness.

Likewise with the second part of the bill – the right to experience the essential comforts of fresh air and the outdoors. Mental health facilities are the ONLY places where people can legally be locked inside for long periods of time. We are being robbed of quite possibly the best short-term remedy that exists – the healing power of nature. This is a critical part of recovery for so many people, but at more than 30 hospitals in Massachusetts, it’s not even possible.

The administrators and lobbyists who fiercely oppose this bill believe that providing civil rights costs too much money. They don’t see that people treated with dignity will avoid repeated hospital admissions and treatment interventions – in other words, reducing costs and the incredible strain on the system.

Cost-effective. Ironic, isn’t it? Providing human rights can SAVE money. Why is it opposed so strongly?

Of course, ultimately, it’s not about the money, but something much, much more valuable: the promise of recovery. When the seeds of recovery are sown, hope and freedom flourishes. Please urge your legislators to support this bill, House 1430/Senate 986, an essential part of our ongoing civil rights movement.

Rights Around the World

Announcing: Rights Watch, Around the States and the World

Still in the formative stages: hoping to publish information on rights situations at psych. facilities in other places besides Massachusetts. Please keep me informed of what is happening where you are!

There are some recent actions and events, with news coverage, happening in the District of Columbia, Missouri, and Virginia, and that will be posted soon.

Thanks to all for reading the blog, and keep checking it out!!

A Hospital Story

I'm pleased to present an eloquent account of life on a psych. hospital unit, written by a friend of mine who also lives in Massachusetts...

My Bad Hospitalization Story
by D. Millman

I’ve been in the psych ward of a hospital a few times to date, and hopefully won’t be going again. I’ve had good and bad experiences. Right now, I’d like to discuss the bad experiences.

I never knew that there were any real rights for patients in the psych ward of a hospital – other than privacy laws and such. I’d never heard of the Five Fundamental Rights, as well as the sixth one that’s currently being worked on. I believe in all of them, and of my experiences in the psych ward of my local hospital.

For a little background, I’ve only been in the psych ward of one hospital, but I’ve heard it’s common at other hospitals. All that I can tell you is about my different experiences within the same hospital.

One thing that I noticed right off the bat, during my first hospitalization there was that patients in the psych ward are treated completely different than the other wards that I’ve been in within that same hospital. I found it dehumanizing. The first thing I notice is that only some of the rooms have hospital beds. The majority of them have what I call slabs. They’re wooden and have a slab of something that’s supposed to be a mattress. It reminds me of the gym mats that we used back in elementary school, but thicker. These slabs are not very conducive to people with back problems. In order to get a real hospital bed, you need doctor’s approval, which is almost impossible to get. I’m sure there are beds in prison that are more comfortable.

Also, regarding the beds, no one changes the sheets for you like they do in the rest of the hospital. If you want them changed, you have to change them yourself, which is not exactly high on the priority list of people in the psych ward. Talk about feeling like the “low man on the totem pole” so to speak. Why do we get treated with such low standards? Why are we seen as “less than” all of the other patients? If it weren’t for us, the people working on that unit wouldn’t have a job. Hello people!

Something else that I noticed right away is food ordering. On the rest of the units, you order your lunch for today any time before, say, 10:00 AM. On the psych ward, however, you have to order tomorrow’s food today. If you want food today, you must have ordered it yesterday. If you forget to order, one of the staff has to call down to the kitchen, which they despise doing, and get you the “house” meal – which is whatever they decide to throw on a plate and call a meal. I’m sorry, but if you’re in the psych ward, you’re probably already confused enough, and to have this thrown on there too, well, it’s just very absurd.

The phone is another issue. We don’t get phones in our rooms, so there is no privacy. There are two pay phones on the unit where you can get or make calls. There is only one non-pay phone on the unit, and it’s near the nurse’s station, where there is no privacy. You have to limit your calls to 3-5 minutes, and then it’s someone else’s turn. We’re supposed to keep track of who’s next in line. Yep, that’s another one of our duties. Also, if you answer the pay phone and you need to locate the individual, you do so by running around the whole ward yelling for them. Also, if you can’t locate them, you’re required to take a message, or ask the person to call back at another time. Great, now they made me a receptionist. Hello people!

Showers are not much fun. There are two on the unit, which sometimes has 20-30 people on it. Don’t know whose brilliant idea that was. Oh, there is another one, but there’s a bath there too, and they only use it when they have to bathe people who can’t bathe themselves – since it can be deemed a suicide risk. I’ve never seen it get used. Oops, there is another one, but it’s down in the locked, isolation section, and no one is allowed down there, unless they’re staying in that section of the unit. One stay I did get “privileges” for that shower, because I was having falling down/black-out episodes, and I didn’t want to feel rushed in the shower. Of course, I had to request it numerous times before someone finally agreed that it might be a good idea.

One thing that I’ve found very helpful in my hospitalizations is getting “grounds” privileges. This is where you’re allowed to leave the unit, escorted by staff of course. Sometimes it’s just to go to the gift shop or a walk around the building. Most of the time, if the weather permits, we get to go outside and walk. It’s one of the best parts of being in the psych ward. You get to be outside, smelling the fresh air, which is very good for health – I’ve heard that there are numerous studies that have proven that fresh air is good for your health. It’s the one time you actually get to feel “free”. Most prisoners are allowed to get one hour of fresh air, so should people on the psyche ward. These are the things that many people take for granted, but have it taken away from you, is just horrible.

The psych ward is so dreary, with bland paint jobs that definitely don’t help those of us who are there for depression-related issues. Being outside, sun or not, is just what the doctor ordered. If my hospital, that does all of the horrible things I’ve previously mentioned, can offer this to us, why can’t all of them? I totally agree with the fresh air rights that we should all be allowed.

Results of Blog Poll

Thanks to everyone who took part in the blog poll, which asked people to rate the top 1-5 problems they have noticed in inpatient psychiatric environments.

I set up the poll to be time-limited, so we would have a tangible result. However, your ideas and observations are not only welcome, they are necessary! Please feel free to keep the comments coming, and if you have any ideas for future polls, please let me know.

And now, the results:

PROBLEM AREAS OF MOST CONCERN AT PSYCHIATRIC HOSPITALS:

(Total of 37 people voting)

1.) Staff attitudes, 81% (30 votes)

2.) Boredom/dreary atmosphere, 70% (26 votes)

3.) No access to fresh air, 62% (23 votes)

4.) [Five-way tie for #4] Poor physical environment, 54% (20 votes)

4.) Miscommunication, 54% (20 votes)

4.) Overmedication, 54% (20 votes)

4.) Over-reliance on medication, 54% (20 votes)

4.) Forced treatment, 54% (20 votes)

5.) [Two-way tie for #5] Communication with outside, 45% (17 votes)

5.) Lack of discharge/aftercare plan, 45% (17 votes)

6.) Understaffing, 43% (16 votes)

7.) [Two-way tie for #7] Restraint/seclusion, 40% (15 votes)

7.) Misdiagnosis/medication errors, 40% (15 votes)

8.) Staff inexperienced, 32% (12 votes)

Happy Holidays!!!

Wishing all readers and advocates a very

HAPPY HOLIDAY Season!

May yours be filled by joy and good tidings. We are on the cusp of making change so that ALL people can enjoy the blessings of happiness and community - in full equality. Stay Tuned!!!

Jonathan Dosick
Blog Administrator, "Civil Rights in Psychiatric Hospitals"

Greetings to all!

Please feel free to comment on our POLL. I've created a closing date just to put some parameters on it.

I wish everyone reading a most Happy Holiday season, and I hope that future years will see more humane treatment of us and our friends and family; and a decrease in abuses at inpatient psych units and homes. EVERYONE deserves this much.

Best,
Jonathan Dosick, Blogger

Massachusetts’ Civil Rights Crisis, Part 2 – The Five Fundamental Rights

Second Post – What Violations Look Like

This is the second in a series of posts that describe the ONLY law that protects basic civil rights in Massachusetts - a law that has been forgotten. Violations are the rule, not the exception. This post describes the (commonly seen) violations that do happen.

What do you see in your State or Country?

What Violations of the Five Fundamental Rights (5FRs) law look like:

Sadly, many of these violations are based on reality – they happen on a regular basis.

Violations of Fundamental Right #1 - Access to Telephones:
- Phones are in public places, such as hallways or dining areas.
- Phones are located near or at nurses' stations, so staff can monitor conversations; staff members listen in on calls.
- Calls are kept unreasonably short.
- Phones are shut off (often during ‘groups’); or private phone areas are locked.
- Staff will not provide money/assistance to make calls.

Violations of Fundamental Right #2 - Access to Mail:
- Mail is opened without the patient present.
- Mail is read by staff.
- Mail is opened for any reason beside suspected transmission of contraband.
- Staff refuses to provide writing materials, such as pen and paper, or postage, on request.

Violations of Fundamental Right #3 - Access to Visitors:
- Visiting hours and visits are kept extremely short.
- Visits are only allowed in common areas, such as dining rooms or hallways.
- Staff members are present during a visit.
- Visiting times are not flexible enough to accommodate patients and visitors.

Violations of Fundamental Right #4 - Humane Physical and Psychological Environment:
- Denial of a safe, private space for resting and sleeping.
- Observation by staff while bathing, using the bathroom, or dressing/undressing.
- Placement (esp. in group homes) with roommates who may endanger a patients’ health and wellbeing; staff is insensitive to trauma issues.
- Shared bathing facilities (i.e., group showers or toilets).

Violations of Fundamental Right #5 - Visits with Lawyers and Outside Care Providers:
- Patients can’t receive or refuse visits from attorneys, outpatient physicians, therapists or clergy.
- Staff won’t allow such visits to occur outside of normal visiting hours.
- On admission or on request afterwards, the patient isn’t given information about free legal services, or staff doesn’t help patients in contacting these services.
- An attorney, if given permission by the patient, is denied access to the client, his/her record; or staff responsible for treatment and care. Also, if that attorney isn’t allowed to attend meetings where the client is present.


Violations of Other Provisions of “Five Fundamental Rights” Law:
- The “Five Fundamental Rights” are not posted in a prominent place, or they are hard to understand or read. Non-English speakers can’t have the rights translated.
- A copy of these rights are requested, but staff refuses to provide it.
- Patients can’t wear their own clothes, keep possessions and money, or don’t have private storage space.
- Patients cannot refuse ECT.

LEGAL ASSISTANCE ORGANIZATIONS IN MASSACHUSETTS:

Mental Health Legal Advisors Committee (Boston)

Intake Hours
8:30 a.m. to 1 p.m. - Mondays, Wednesdays and Fridays

Intake LinePhone: (617) 338-2345 press "1" Toll Free Phone:1-800-342-9092 press "1"

Email: MHLAC@mhlac.org

Disability Law Center (Protection and Advocacy agency in Massachusetts)

(Main) Office, Boston:
Phone: (617) 723-8455
Toll Free Phone: (800) 872-9992

TTY: (617) 227-9464
Toll Free TTY: (800) 381-0577
FAX: (617) 723-9125

Western Mass. Office, Northampton:
Phone: (413) 584-6337
Toll Free Phone: (800) 222-5619 Voice
TTY: (413) 582-6919
FAX: (413) 584-2976

E-mail: mail@dlc-ma.org

Center for Public Representation (Newton and Northampton)

Newton, MA Office:
Phone: (617) 965-0776
Fax: (617) 928-0971

Northampton, MA Office:
Phone and TTY: (413) 586-6024
Fax: (413) 586-5711

Email: info@cpr-ma.org

TO FILE AN OFFICIAL (STATE) COMPLAINT BY PHONE, CONTACT:

Disabled Persons’ Protection Commission (DPPC) 24-Hour HOTLINE:

Phone/TTY: 1-800-426-9009


The next post will look into the history of the law, and how and why it is so brazenly ignored.

Massachusetts’ Civil Rights Crisis, Part 2 – The Five Fundamental Rights

First Post – The Five Fundamental Rights Law

The landmark 2000 study “From Privileges to Rights,” published by the National Council on Disability contained these words:

Daniel Fisher, a psychiatrist, testified that some states, such as Massachusetts, had to pass legislation to ensure the human rights of people in institutions who are labeled with psychiatric disabilities, such as the right to make a phone call or have visitors, legislation that would not be necessary if people labeled with psychiatric disabilities did not lose their ordinary citizenship rights.

The law Dr. Fisher refers to is called the “Five Fundamental Rights” law. Sadly, twelve years after its passing, this law is still rarely enforced, and the appeals process is almost nonexistent – leaving thousands with no guaranteed civil rights - in hospitals and group homes.

This post will explain the Five Fundamental Rights (5FR) law. This law applies to Massachusetts only. However, many other states have the same or similar laws and/or regulations. What do you see happening in your State?

In the interest of readability, I am paraphrasing the law, and I’ve added bold type for emphasis. You can read the full language of the law here.


The “Five Fundamental Rights” (5FRs) Law:

Massachusetts General Laws, Chapter 123, Section 23

(As defined by Chapter 166 of the Acts of 1997, An Act Relative to Certain Rights of Persons with Mental Illness):


Rights of persons receiving services from programs or facilities of department of mental health

This law applies to all persons receiving services run or licensed by the Department of Mental Health, including all state and private hospitals, community mental health centers, and/or residential programs. These rights are to be exercised without fear of harassment or reprisal, including denial of appropriate treatment.

(a) The right to reasonable access to a telephone, to make and receive private calls. Assistance making calls must be available when necessary.

(b) The right to send and receive unopened and uncensored mail. On request, stamps and writing materials must be made available in reasonable quantities, as well as help writing and mailing letters.

(c) The right to receive visitors of one’s choice, daily and in private, at reasonable times. There must be some flexibility of visiting hours to accommodate the needs and wishes of individuals and their visitors.

(d) The right to a humane psychological and physical environment, including privacy and security in sleeping, dressing, bathing and toileting. This right does not require individual sleeping quarters.

(e) The right to receive or refuse visits and calls from an attorney, legal advocate, doctor, clergy member or social worker. These calls and/or visits can be outside of normal visiting hours, and can happen regardless of whether or not that person initiated or requested the call/visit.

ACCESS TO ATTORNEYS:
Facilities must give access to attorneys working for Massachusetts’ Protection and Advocacy agency – the Disability Law Center in Boston; the Committee for Public Counsel Services, a State office; and any agency funded by the State’s Legal Assistance Corporation to provide free legal services. The facility must designate ‘reasonable’ times for attorney visits, and provide help in contacting them.

The facility must provide the name, address, and phone number of the legal agencies listed above on admission and on request at any time after.

If an attorney is contacted, and only with consent of the client, the attorney shall have access to:
• The client;
• His/her medical records;
• Staff responsible for care and treatment; and
• Any treatment/discharge planning meetings with the client.


Proposed sixth right:
(Filed as legislation in 2005, 2007 and 2009; to be refiled in 2011.)

(f) The right to daily access to fresh air and the outdoors.


Additional provisions of the law:

POSTING OF RIGHTS
• The Five Fundamental Rights must be posted in appropriate, conspicuous places, in language that is easy to understand. Type size should be readable.
• On request, a copy of these rights must be provided to any client.
• If clients can’t read or understand English, the law must be translated.

ADDITIONAL RIGHTS
• To wear one’s own clothes;
• To keep and use one’s own possessions;
• To keep and use a reasonable sum of one’s own money;
• To have private, individual storage space; and
• To refuse shock treatment (ECT) or lobotomy.

RIGHT TO APPEAL
According to the law, any “dispute” regarding the 5FRs must be documented and “subject to timely appeal.” However (and this is the focus of our advocacy work), the appeals process is badly broken.

Exceptions (But NOT the rule!!!)
TEMPORARY Suspension of Rights

Suspension of Rights #1 (Telephones) and #3 (Visitors):
These exemptions apply only to inpatient facilities and can only be temporary. Suspension may occur only in the following circumstances:
• The suspension is on an individual basis;
• Suspension is issued by a hospital administrator or their designee;
• Suspension can only occur if there is a serious risk of ‘harm’ to self or others. The reason for suspension must be documented, and suspension can only last as long as the potential ‘harm’ exists.
• If use of the phone or visits cause ‘significant disruption’ in the functioning of the unit.

Suspension of Right #2 (Mail):
If a hospital administrator or his/her designee has ‘good cause’ to believe that a patient is receiving ‘contraband’ (i.e., drugs or weapons) through the mail, (s)he may open and inspect such mail.

However, if this is done, the mail must be opened in front of the patient, and staff may not read the mail. The purpose for opening must be documented.

Suspension of Additional Provisions of the Law:
Any of these rights can be denied by hospital administrators or their designees, provided that the reasons for denial are recorded in the client’s record.

What do you see happening in your state or country? Your observations are very important - please post!!!

Introducing the Civil Rights Poll!!

I’ve added an interactive poll on the right-hand side. The answer topics are based on the answers received from an earlier poll, conducted for the Facebook group with the same name as this blog. Please contribute; the survey is confidential. If there are any topics missing, please let me know!

Thank You!!!

New stories of violations in Mass.

Coming very shortly: Part Two of ‘Massachusetts’ Civil Rights Crisis,’ looking at the basic rights law in Massachusetts.

Here are two recent anonymous online posts, found on Citysearch.com, regarding Arbour Hospital, the facility in Massachusetts we are focusing our advocacy efforts on. Please be aware that it may be disturbing.

These are just some stories that demonstrate the egregious and criminal nature of the discrimination the consumer/survivor/peer community experiences.

11/10/10
Should Be Shut Down

If I could give this place negative stars, I would. My husband was in there for several days recently--he was sent because they were the only place that had a bed and took his awful insurance plan--and he was completely traumatized. When he arrived they were fumigating his floor for bedbugs and they put him on another floor where he had no bed and no staff knew who he was.

He was given no information, no one was friendly, he was seen for 30 minutes total in 48 hours, the other patients were all violent and very loud, where my husband was simply depressed. There were fights in the hall that were slow to be broken up. Several patients were doing drugs in his room that one had smuggled in. Security was lax and they forgot to give him his medication for 36 hours.

Further, this place is dirty, dank and disgusting, the staff were extraordinarily rude to me with the exception of two night male nurses and the receptionist who gradually warmed to me. The nurses by and large seemed like they should be admitted.

My husband's case worker took 6 hours to call me back on the first day and then refused to come upstairs and meet with me, saying he was too busy. The second day, when he again refused and I said I would wait in the lobby until he was free, he accused me of harassing him. I don't think my husband's outside Psych received a call back until 8 hours had passed.

The only bright spot in this was the case worker's manager (who I escalated my concerns to) who was very kind, apologized for the case worker, and worked with me to get my husband transferred to McLean. We were very very lucky-- If I had not spent 36 straight hours on the phone and kept on despite being repeatedly told no, I never would have been able to transfer him. As it was, if he'd spent one more day there, insurance would have refused to move him.

If your loved one needs to go into the hospital, research ahead of time and go directly to that hospital. Do not ever allow them to take your loved one to Arbour. It is a mystery to me how anyone could ever get better there. I recommend McLean, which is like day after night.

11/09/10
the biggest mistake I made as a parent

I have never had to bring my child to a mental health facility before. Arbour was the first one we were told was open and to go. The staff not only did not understand a thing I was saying but they treated my child who was so scared like a piece of discarded trash. Their idea of family therapy was to put an entire family of divorced mom and dad and only one extension of my ex's family in the room with my daughter and myself and the social worker led my daughter to actually turn on me as a parent. In addition I will also make it very clear in this posting that the social worker who was supposed to help my daughter who is under aged actually told my child on a one on one meeting that my child should just call someone else and see if she could live with them. Said social worker told my child that she didn't think my daughter should live with either me or my ex husband. It not only disturbed my daughter and limited her trust in people and therefore did not assist in her recovery but it also shows me that it is AMAZING how these people think they know a child in less than 7 days....who does that? Not only do I think that you should refuse to send a loved one to this facility but I think that the adolescent ward should not even exist.

The Trouble With Fresh Air (?!)

People are constantly asking me, “why on Earth would anyone oppose fresh air as a basic right?” After which, I often tell them they’d be surprised! However, I often don’t have the time to explain the many reasons (and excuses) our opponents offer. Enter the brave new world of blogging, however, and I can share them, in their own words.

So, I have typed up the testimony submitted by the two large lobbying firms for Mass. hospitals AGAINST adding “access to fresh air and the outdoors” as a basic human right, and I present them to you. I apologize in advance if they produce mild feelings of nausea!

Testimony By The Massachusetts Hospital Association (MHA) and the Massachusetts Association for Behavioral Health Systems (MABHS) In Opposition to the “Five Fundamental Rights enforcement/fresh air rights” bill (House Bill #1945/Senate Bill #743)

Submitted for September 23, 2009 Hearing of the [MA] Joint Committee on Mental Health and Substance Abuse, State House, Boston.

FIRST, A FEW ITEMS TOO INTERESTING TO IGNORE:

• Enforcement of existing “Five Fundamental Rights” law was a major part of the bill, but this testimony ignores that part entirely – for BOTH lobbyist groups testifying in opposition! A guilty conscience, perhaps?

• MABHS’ testimony was the first presented at the hearing – the rest was in favor - but after reading this testimony, MABHS’ Executive Director left the hearing room, and so was unable to listen to our testimony, despite repeated statements in the past expressing willingness to work with us and listen to our concerns.

• The MABHS testimony is nearly a word-for-word, carbon copy of the previous session’s testimony, given in June 2007.

Massachusetts Hospital Association (MHA) Testimony

MHA opposes HB1945/SB743. This bill would mandate hospitals and other facilities that treat mentally ill patients to provide daily access to fresh air and the outdoors. Although our member hospitals believe that the ability of patients to have daily access to the outdoors is desirable, we are unable to support these bills. MHA believes these bills pose significant safety and operational concerns that would be untenable. Clinical staff shortages, often exacerbated by cuts in state funding, are a primary hindrance to the effective implementation of these proposals. Patient clinical presentation and safety must be the key determinants in any decision process. Potential physical plant and logistic barriers must also be taken into account. As these considerations are not part of the provisions set forth in HB1945/SB743, MHA is unable to support either bill.

Massachusetts Association for Behavioral Health Systems (MABHS) Testimony

On behalf of the Massachusetts Association for Behavioral Health Systems (MABHS), I [Executive Director David Matteodo] appreciate the opportunity to testify before the Committee on Mental Health and Substance Abuse on S.743 and H.1945. The MABHS represents 47 inpatient facilities throughout Massachusetts that collectively admit over 45,000 patients annually for behavioral health treatment. Our facilities provide the overwhelming majority of acute inpatient psychiatric and substance abuse services in the Commonwealth.

Although our hospitals believe that the ability of patients to have daily access to the outdoors is desirable, we are unable to support these bills. It would make the right to “daily access to fresh air and the outdoors” one of the Fundamental Rights of patients, which could only be revoked if certain criteria were met. In the past, we have met with the main proponents of this Legislation to review our concerns, and are willing to continue to meet with them to see if there are alternative ways the hospitals can address the issue. However, we hope that the Committee does not report these bills Favorably for a number of reasons, as summarized below.

• S. 743 and H. 1945, by adding the right to go outside to the Patients’ Rights law, would create real safety issues for hospitals. Many of the patients who are admitted to our facilities come to us because they are a danger to themselves or others. Many of these patients would like to leave; they do not think they should be in the hospital. However, our hospitals are entrusted by families, loved ones, and the communities to keep the patients safe. Since many hospitals in Massachusetts do not have enclosed outdoor areas, escorting every patient outside is not possible. We cannot allow unsafe situations for our patients or for the communities our hospitals are in. How would families react if patients were eloping [escaping] because we were unable to contain them safely? The families and communities entrust the hospitals to keep the patients and the communities safe. If these bills were to pass, that safety could be jeopardized.

• Our hospitals provide short term acute treatment. People come to our hospitals for treatment of acute psychiatric illnesses and stay for approximately 9 days. This is much different from the DMH State Hospitals where patients can stay for many months. Our major priorities are safety and treatment and stabilization of the patient’s symptoms. We are trying to treat patients so they can rapidly go back out to the communities as productive members of society. We are not trying to penalize or restrict patients. Just as acute hospitals seek to stabilize general medical conditions and discharge patients back to the community, so do mental health facilities – the difference is our hospitals are treating psychiatric illnesses, and in many cases, patients with both a psychiatric and medical illness. We treat our patients with respect, care, and dignity. The restrictions on patients going outside are not for punitive reasons, but rather for the safety of the patient, the unit, and the community. We do not believe our patients or hospitals should in any way be compared to prisoners or prisons, where the length of stay may be years.

• If these bills were to pass, it would require either additional Capital or Staffing costs for many hospitals. Hospitals would have to either build fenced-in areas; or if unable to do that, hire many new staff to escort patients outside. Already the inpatient mental health units are under extreme financial pressures, both externally and internally within their own hospital systems. Additional added costs will raise questions about the ongoing viability of many units, as hospitals struggle to find resources to fund a new mandate. Access to mental health services could suffer if the mandate forced hospitals to close their units. It is impractical for certain urban hospitals with no secure outdoor areas to allow every patient who asks to go outside.

• Our hospitals in no way would endorse the idea of Outdoor privileges being taken away because of a punishment. We agree that going outside can often be beneficial for patients, and try to allow it when possible and safe. Many of our hospitals already allow patients outdoor access where they can safely provide it. However, unfortunately due to physical plant and safety reasons, not all facilities can allow it, especially units in acute general hospitals. Hospitals are also concerned with the movement towards Smoke Free Campuses and how a mandate such as called for in these bills could be complied with safely.

• In the last Legislative Session, there was suggested Re-Drafted language that took into consideration patient clinical presentation and safety. That language was an improvement over these versions and could be further improved by adding “and the ability of the facility to provide this right safely” as a criteria for providing outdoor access. This would clarify the situations where because of physical plant and logistical issues, a unit simply could not safely allow patients broad access to outdoors.

In conclusion, we urge the Committee to not refer these bills favorably in their current forms. Our facilities are committed to providing as safe and humane environments for our patients as possible. We are willing to work with the advocates of this bill, or with the Committee if it so desires. However due to the above reasons, especially the safety concerns, we are not able to support these bills. Please do not report these bills Favorably.

MASSACHUSETTS’ CIVIL RIGHTS CRISIS, PART ONE – BACKGROUND

Massachusetts has long been considered a global leader for medical research, treatment, hospitals, and innovation. For medical care, the reputation is deserved: Beth Israel-Deaconess, Mass. General Hospital, Childrens’ Hospital, Dana-Farber Cancer Center and the Joslin Diabetes Clinic, among others, are world-renowned. However, the State’s progressive reputation still hasn’t caught up with the hard realities its consumer/survivors face.

In 1833, Worcester State Hospital, the first State Hospital in the United States, was opened. In 1841, Dorothea Dix, considered by many to be the first mental health advocate, discovered and campaigned against cruel and inhumane facilities near Boston. She actively lobbied State Legislatures and the U.S. Congress for the construction and expansion of public hospitals, the first of which was Worcester State. Early on, some such hospitals were based on Quaker ideals of “Moral Treatment” – i.e., asylums meant to be restful and humane places where patients were treated with respect and ample access to fresh air and nature. But despite the lofty goals and good intentions of the concept of “Moral Treatment” fell out of favor, and asylums became notorious “snake pits”.

In 1966, the shocking documentary film “Titicut Follies” exposed conditions at Bridgewater State Hospital. But still, forty years later, the situation for survivors in the criminal justice system here is quite grim.

During the 1970s, and 80s, Massachusetts was home to some of the most well-known mental health activists, including Judi Chamberlin, Dan Fisher, and others. The Mental Patients’ Liberation Front (MPLF) was an early, outspoken activist group, which established the famed Ruby Rogers Drop-in Center in Somerville. A court ruling named for Rogers established the right to refuse treatment.

In 1977, the court ruling Brewster vs. Dukakis (also known as the Brewster Consent Decree) was one of the major steps in what is known now as deinstitutionalization, resulting in major discharges at Northampton State Hospital.

Many of the country’s most celebrated literary figures have written about their experiences in the Massachusetts mental health system, especially at psychiatric hospitals, including: Susanna Kaysen (Girl, Interrputed); Lauren Slater (Welcome to my Country and Prozac Diary); Augusten Burroughs (Running With Scissors). Authors Sylvia Plath and Anne Sexton spent time at McLean Hospital, as did musicians James Taylor and Ray Charles.

And to this day, many top names in mental health advocacy are based in Massachusetts, including Dr. Fisher, Pat Deegan and Robert Whitaker.

MASSACHUSETTS' CIVIL RIGHTS CRISIS - A Series of posts

This is a series of posts that will serve as an introduction to the rights issues we are dealing with in Massachusetts. I hope this will put our efforts into sharper context, and will resonate with readers outside of Mass. First, I will cover the basic history of mental health in Massachusetts, and then I will go over the "Fundamental Rights" law: what it means, why it isn't working, and what the hosptal "landscape" looks like here. Finally, I will describe our agenda and action plan. I hope you find this interesting and useful!!

Privileges to Rights - A Passage of Note

The following is an excerpt of the 2000 "From Privileges to Rights" Report, published 10 years ago by the National Council on Disability, in which Dr. Dan Fisher talks about the "Fundanmental Rights" legislation in Massachusetts - the focus of our current struggle.

Sadly, things haven't changed much.

(Thanks to Dr. Fisher for permission to reprint.)

Daniel Fisher, a psychiatrist, testified that some states, such as Massachusetts, had to pass legislation to ensure the human rights of people in institutions who are labeled with psychiatric disabilities, such as the right to make a phone call or have visitors, legislation that would not be necessary if people labeled with psychiatric disabilities did not lose their ordinary citizenship rights. It is important to note that both in institutions and in community facilities, rights are referred to as "privileges" that must be earned, generally by compliance with treatment. Such so-called "privileges" as using the telephone or having access to fresh air must be recognized as basic rights that may not be infringed. Just as it would be intolerable and unacceptable for people to lose their rights when they enter a hospital for medical treatment or surgery, such policies should be similarly unacceptable in psychiatric facilities.