Today I want to discuss something widespread in mental hospitals across the country. Sure, you can find cases of great hospitals, unfortunately there are a lot of .. well ..not so great ones.
How you are treated in hospitals depends on the hospital staff. Hospital staff are basically free to ignore the law with little fear of meaningful consequences. While in theory your rights are protected by law, in practice you have little protection:
||In most cases it is your word vs the staff. You are a mental patient, they are licensed professionals, and they write the logs.
||The staff is protected by various levels of legal immunity, you have nothing.
||The regulatory/accreditation agencies are fairly toothless.
a. Your claims have to fall into their jurisdiction.
b. They have to substantiate your claims with records or witnesses.
c. The proof must be iron clad perfect. The slightest discrepancy voids it.
d. Depending on the agency you may not be informed of any results.
e. Then the agency may cite the hospital and request a response.
f. The response is usually to train staff (yet again).
g. If you feel this is insufficient or disagree, tough. You have no recourse.
h. The hospital has its lawyers, medical groups, consultants, and lobbyists. You don’t.
i. In most cases they keep the investigation secret. You have no idea what happened.
||The police are unwilling to get involved even when staff violate criminal law. They defer to the “professionalism” of the staff. The Fremont police officer who refused to even take a criminal report on staff assault suggested he would take the report “if the staff used something like a baseball bat”. He was also reluctant to investigate Fremont Hospital because the staff didn’t like the police bringing their guns into the hospital.
||Civil litigation is difficult, time consuming, and expensive. Psychiatric medical malpractice is difficult to prove and does not pay the lawyer as well as regular medical malpractice.
||A staff vs patients attitude “white wall of silence” to invalidate your claims.
||The hospital will follow “risk management” guidelines regarding your issues. Generally this means denying anything happened. It is doubtful you will get any meaningful reform from the hospital itself. In theory and words the hospital protects patients, but in deeds they protect themselves and the staff.
The only real protection you have against abuse is the morals and professionalism of the staff. If you are lucky, they will treat people with psychological disorders as patients and human beings. If not, you are viewed as a “psycho” to be controlled. While the quality of individual staff members will vary, the hospital culture itself will be your best indicator of how you will be treated. If the hospital has a reputation for requiring their staff to follow the rules, treat patients humanely, and discourages a code of silence (the “white wall of silence” or “white code of silence”) then you have a good chance of actually being helped. On the other hand if the hospital has a reputation for ignoring problems, allowing mistakes to be covered up, and hiring substandard staff then you will likely be further damaged. In the “Consumer Info” section there are some suggestions on how to tell the difference, and some suggestions on what to do to protect yourself.
Another issue is how acute mental hospitals operate today; in these HMO driven times they are very cost conscious. The insurance company wants you out as soon as possible and this means medications. The days of talking to a therapist are over. Today you will be examined, drugged, observed, then turned loose with an absolute minimum of contact with the staff. Staff costs money, so only the absolute minimum required are on duty. This means that there are few resources available for you to just sit down and talk with someone. The staff on the ward with you are the lowest paid and least trained. Therapists are not usually available outside set group therapy.
If you start to “decompensate”, the staff will do little other than to demand you change your behavior and take more meds. If you decompensate enough to cause trouble then they will get physical, and since there are few staff on duty, this threshold is very low. The staff cannot afford to have you set off the other patients, so they react very quickly to any disturbance. At this point you will be forced to take sedatives and/or anti-psychotics and possibly secluded or restrained as well. Thus an easily preventable problem escalates into a life (yours) threatening situation. Patients die in restraint. While the hospital will give lip service to “de-escalation” procedures, it is quicker and cheaper to just drag you into a room strap you to a bed and shoot you full of drugs.
The “white wall/code of silence” has two aspects. The tracking and disciplinary systems are run by medical professionals for medical professionals. The information is kept from the public by law. If the watch dogs tend to turn a blind eye towards misdeeds, the public is none the wiser. This allows serial killers to masquerade as angels of mercy who freely move from one hospital to another. Secondly staff supports staff. If one staff witnesses a misdeed, they won’t blow the whistle. They don’t want to alienate their co-workers.
What We Want:
1. Recension of the 5150, mitigation of its civil rights impact.
2. Correction of the hospital log to reflect what really happened.
3. Meaningful and verifiable changes to ensure future patient safety and rights.
“I want to see a mighty flood of justice, a river of righteous living that will never run dry”