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Community Perspective

Doctors at API were right 50 years ago

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The Alaska Psychiatric Institute opened its doors in 1962 with 225 beds and a footnote in American history. The warehousing of the disabled was coming to an end and API was one of the first state psychiatric hospitals that was built with a mission statement of preparing patients for release and community care.

It was never fair for the disabled to be locked up indefinitely with no access to the outside world, but that was a common practice prior to the 1960’s. To successfully release patients, API doctors from 1962 to 1972 adopted new plans for patient care. First was the recognition that “the traditional hospital routine perpetuated the return to hospitalization” and that keeping patients connected with the community was an important part of successful release, along with teaching coping skills.

The positive lessons learned by staff at API in the 60’s concerning the successful release of psychiatric patients was forgotten by the time I was a patient in 2003. Management at API was going in a new direction. Instead of improving a patient’s rights and choices and preparing an individual to go back to society and community care, patients at API were cloistered into a system of care that was very similar to a jail. And then released, oftentimes back to the streets with insufficient preparation.

The enormous failure of the Department of Health and Social Services in the 1990’s was to look for short-term economic gains and convenience in psychiatric patient care, as opposed to long-term patient recovery. Today API concentrates on psychiatric patient stabilization with primarily psychotropic drugs. And the same could be said for 40 or more acute care psychiatric units around the state that are poorly designed and poorly equipped to help an individual in psychiatric crisis return to society and community care.

As a mental health advocate, I believe well run locked psychiatric facilities can be necessary. My struggle has always been to encourage state and private psychiatric facilities in Alaska to provide humane treatment, do no harm, and give people with a mental illness the best opportunity to rejoin society. In my opinion, as of now, locked psychiatric facilities and units are 0 for 3 when it comes to protecting patients and there is plenty of blame to go around starting with pick a governor or legislature.

Millions of dollars are spent by the Department of Health and Social Services and others providing care for approximately 10,000 acute care psychiatric patients annually. But the clients in locked psychiatric facilities are not being asked what they need for protection and recovery. And up to now there have been no on-going independent patient exit polls. For all intents and purposes, disabled psychiatric patients in Alaska are without a voice.

There have been occasions when state-run Alaska Psychiatric Institute dropped patients off at the Brother Francis Shelter after discharge with no follow-up. Without a long-range community treatment plan there is a higher possibility that a person dropped off at a shelter will become or remain homeless after release from a psychiatric institution.

As a state, Alaska has a very poor record of protecting psychiatric patients from mistreatment. The state of Maine, 36-years-ago, added the following statement to their psychiatric patient grievance procedure regulations: “Under no circumstances shall the remedies requested in a grievance be denied nor the processing of a grievance be refused because of the availability of a less formal procedure.” The Alaska Legislature must require that all of Alaska do the same. 

In the present legislative session, it should be mandated in law that the treatment of psychiatric patients in acute care facilities and units (there are approximately 40) should be optimized for patients’ success when released. And the second issue that should be taken up by the Legislature: Give disabled psychiatric patients a voice by improving their grievance and appeal rights statewide.

Faith J. Myers is the author of the book, “Going Crazy in Alaska: A History of Alaska’s Treatment of Psychiatric Patients.” She has also been a mental health advocate for over 10 years.

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