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Alaska


API patients soon to get more rights
TENACIOUS: One former patient fights for practices that will promote healing.


By LISA DEMER
Anchorage Daily News

(Published: July 26, 2004)

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New policies and procedures born of the complaints of a former patient are gaining ground at Alaska's state mental hospital.

The changes at Alaska Psychiatric Institute stem from a push to expand patient rights and to end practices that the patient, Faith Myers, argued jeopardize healing.

Myers, 52, has been hospitalized five times at API. She has schizophrenia.

After her most recent stay there last fall, Myers, along with her partner, Dorrance Collins, began raising concerns about male staffers working in women's living quarters, the inability of patients to pick treatment staffers of their own gender, and the hospital's complicated system for earning privileges, among other issues.

In all, they brought 19 specific complaints to the API governing board, the Alaska Mental Health Board, legislators, hospital inspectors and others.

The governing board provides oversight but normally does not investigate individual complaints. It created a grievance committee in April to handle Myers' concerns. The committee found that many were valid and recommended changes. On Thursday, the board accepted the committee's work and set deadlines for new policies and procedures.

"It's more than I ever thought I would get, but I still would like to see more," Myers said. She served on the committee along with Collins, current and former API staff members, governing board members and an attorney with the Disability Law Center.

Myers' efforts will help the hospital improve, said Ron Adler, API chief executive officer. Staffers try to create a healing environment but the current, aging building can make that difficult, Adler said. A new hospital is being built on API's grounds and will be ready for patients by spring.

The governing board debated the grievance in a closed session because of confidential patient and staff information that was discussed, said Aleen Smith, governing board chairwoman and a former API patient.

The board agreed that:

API will create a written policy to prohibit staff members from routinely entering the living areas of opposite-gender patients. That has become the practice already, said Jane Barnes, API nursing director. Before, male staffers would go into women's bedrooms and bathrooms to, say, check on patients or perform housekeeping, and that traumatized and embarrassed women, Myers said.

The hospital should make every effort to allow patients to pick between a male or female doctor, therapist or off-grounds escort. Myers had wanted patients to be given an absolute right to pick the gender of a staff member providing intimate care. She said she will seek legislation to accomplish that.

API will rethink its system in which patients earn privileges, with a new system to be in place by 2006. Currently patients can gain privileges such as going to arts and crafts class or ordering out for food if they cooperate in treatment and function well. Different API units operate under different systems, and patients struggle to understand them. Adler said later that some hospitals abandon such systems altogether and work with each patient individually.

Treatment documents must be legible and understandable. Patients had been labeled as uncooperative if they wouldn't sign a treatment plan because they couldn't read it or it contained jargon. Hospital medical director Duane Hopson was asked to issue a directive on legibility.

All patients must be allowed a chance to go outdoors or, if the weather doesn't allow it, to the hospital gym. In the past, some patients were restricted to their living units because of safety or treatment issues. The medical team at API agreed with Myers that that wasn't a good practice and has begun to allow them to get exercise and fresh air, Adler said.

Myers also had wanted hospital staff members to wear uniforms or at least vests so that patients could easily distinguish hospital employees from other patients, especially when someone is giving orders. Adler said the hospital will adopt a more professional dress code but uniforms look too institutional.

"I can promise you we are not going to go down that road," he said later.

Myers' concerns about privacy were especially important, said Edie Zukauskas, the Disability Law Center attorney who served on the committee at the request of the hospital and Myers.

Psychiatric patients are particularly vulnerable and often are not aware of their rights, she said. "We have been favorably impressed with API's response to this grievance," she said.

At API, two-thirds of the psychiatric nursing aides, who provide most of the direct care, are men, as are three-quarters of the psychiatrists and psychologists. But most of the nurses and social workers are women. As of Friday morning, API had 60 patients -- 36 men and 24 women.

Myers said many women patients have suffered from sexual abuse and may feel threatened anew in the hospital by male staffers.

One former API patient, Roslyn "Ross" Wetherhorn, told the governing board in April that she was sexually abused -- fondled and propositioned -- by a male staff member in 2000. She didn't report the abuse initially, she said in a telephone interview. The hospital addressed the problem recently, after she posted information on a mental health consumers online information network, Wetherhorn said. Adler seemed genuinely concerned, she said.

Since he came on board in March 2003, every complaint of sexual misconduct at API has been investigated and usually referred to police, Adler said. There are few such complaints each year and about as many are between patients as between staffers and patients, he said.

In the new hospital, patients will have private bedrooms and bathrooms. Their rooms also will be monitored so that if someone steps in unwanted, a nurse will know immediately, he said.

Myers said she was disappointed the hospital did not commit to putting more changes into written policy.

In the meantime, a suit filed on her behalf against the hospital is awaiting a state Supreme Court ruling on an appeal.

The suit aims to prohibit the hospital from forcing patients to take medication unless it can prove it is in their best interest. Myers has argued that it should be her choice and that she is now on an antipsychotic drug that helps her. A state Superior Court judge in a preliminary ruling sided with the hospital, and Myers has appealed.

Daily News reporter Lisa Demer can be reached at ldemer@adn.com and 257-4390.


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