Locked Away for Years, Nobody Cares

What if someone you loved had a mental disorder that nobody knew how to treat? The disorder causes your loved one to act out against others, because they see hallucinations or believe delusions about others trying to harm them.

Sometimes, the delusions might cause them to act out, sometimes even harming other people.

Medical and psychological science don’t yet have all the answers. Sadly, we cannot treat, much less cure, everyone with every concern.

But medicine and science have come a long way from the 1950s, when all we did was handcuff people to chairs or strap them into beds in order to deal with unruly or violent behavior.

Or has it?

According to a story last week reported by the Associated Press in The Washington Post, there are dozens of cases of people reportedly being locked up, sometimes in restraints, for years for these kinds of behaviors — often against the law, and against all modern treatment protocols.

In Florida, the state lost a lawsuit in 1998 and was forced to pay $18 million for strapping a man to a bed or wheelchair for 2 1/2 years.

Connecticut has paid $600,000 a year since 2002 to house a former patient at a special facility in California as part of an out-of-court settlement. He had been tied to a bed in a small, concrete room at Connecticut Valley Hospital in Middletown for more than a year, said Susan Aranoff, an attorney with the nonprofit Connecticut Legal Rights Project who fought for his transfer. […]

In Virginia, one man was locked in a three-room suite for 15 years and another patient was held in a similar setup for five years. Connecticut and Florida have paid millions over allegations that they tethered patients to furniture for years.

Federal law requires that seclusion or restraints — including drugs — be used on patients covered by Medicare or Medicaid only in emergencies to protect other patients and staff. Such measures can be used for more than 24 hours only if a physician deems it necessary, and only if a doctor updates that assessment daily.

The three-room suite is a luxury compared to some cases reported upon. And the 24-hour measure is easily bypassed (as hospitals have learned) by simply having a doc sign off on the chart once a day (with no actual new assessment being performed). Although ethically, no doctor should ever do such a thing, it’s done nonetheless as the path of least resistance for these difficult-to-treat patients.

The answer is simple — money and resources. It’s cheaper to lock people up in their own private suite than to provide the 24/7 care and treatment to help them find a road to at least partial recovery.

In 1997, Pennsylvania enacted stricter policies against those techniques, trained staff in crisis management and established minimum staffing levels for its psychiatric facilities. Today, the state does not seclude or restrain patients for extended periods and rarely uses either method at all, according to the state mental health agency.

Such efforts can be costly, but proponents cite them as proof that with the right support, any mentally ill person can improve enough to safely interact with others.

In a time of a bad economy, however, the first services to be cut are often those that are seen as unnecessary — such as cutting back on proper mental health care and services for the poor and indigent.

So it comes down to the age-old societal question: Do we care about those who are worse off than ourselves? And if so, how willing are we, as a society, to ensure such people are taken care of properly, rather than warehoused in locked wards, tied to beds and wheelchairs, as was common in the 1950s and 1960s?

Do we really want to go back to such “care” or do we want to recognize that such disorders could affect anyone, at any time, even someone we love? In the months ahead, the new government will help forge decisions on such care (through funding of federal Medicare programs and such). Decisions that can ensure proper treatment and care for not just dozens, but hundreds of people who need help — not restraints — from society.

Read the full article: Mental patients isolated for years despite laws