The Informed Constituent: BACK TO THE DARK AGES
By George Ebert
Published: August 8, 2006

The Informed Constituent: BACK TO THE DARK AGES

Two bills have quietly passed through the Assembly and Senate that have thousands of mental health representatives and advocates concerned. On August 3rd, several members of the Mental Patients Liberation Alliance held a press conference at the State Capitol to increase public awareness and gain support in opposition of the bills.  The people who will immediately be affected by the new legislation are currently behind the locked doors of treatment facilities, most likely unaware of the legislation and unable to voice objections. 

Assembly Bill 9986-A and Senate Bill 6706-S propose to amend current legislation that would expand authorization of the use of restraints in all treatment facilities. The measure would be certain to increase the use of restraints on people as it shifts responsibility of highly invasive procedures to less qualified personnel.  In some circumstances, authorization would extend to the most senior member of the staff on site, inappropriately allowing the staff members who interact most closely with recipients of mental health services to order and execute the restraint procedure.  

Historically, such conditions have created a high frequency of restraint and seclusion abuse, such as using the procedures to dominate, sub-ordinate, and punish individuals.

Human rights activist Lauren Tenney co-chaired the New York State Office of Mental Health 1999 Children’s Subcommittee of the Restraint and Seclusion Task Force, which is charged with updating state policy to meet federal regulations. Tenney said, “These life threatening practices negatively affect those who are subjected to them—as well as those who witness and live in fear of them.  These practices will be used on children, adults, and senior citizens… For the upwards of 80% of children who have survived physical and/or sexual abuse, these practices are especially deleterious.”

The legislation is sponsored by Senator Morahan and Assemblyman Rivera, both of whom chair their respective mental health committees. Opponents criticize the two legislators for not including testimony from people who have been, or who are at risk of being, subjected to restraints.  “Thousands of people subjected to restraints have described the practice to our members as being ‘violent, dangerous, and dehumanizing’, stated Anne Dox, a coordinator of the NY State Mental Patients Liberation Alliance.  Dox also cited the Hartford Courant DEADLY RESTRAINT Investigation DATA BASE created in 1998 that ‘chronicles hundreds of deaths and injuries due to restraint procedures’.    

A restraint procedure involves what is generally called a “take down”—tying the person down, forcibly injecting drugs, and then putting them in seclusion. Since 1994, the Office of Mental Health has been compelled to regulate these practices and to seek the reduction and subsequent elimination of their use. This legislation would expand the use of this high-risk intervention. The possibilities of injury and death will increase as well as an expansion of liability and litigation for the State.

According to the U.S. General Accounting Office in Washington D.C. (Health, Education, and Human Services Division), NY State taxpayers spend over $6 billion annually for public mental health services. Staff trading had been found to save the state money by directly reducing the frequency of restraint-related staff injuries, which represent costs of sick leave and overtime payments for staff to cover the shifts. Advocates say it is imperative to redirect current funds toward more education and training that has been shown to effectively result in the in the reduction and elimination of restraints (and seclusion). The report is available online (search GAO-HEHS-99-176, 1999 p. 21).

NY State is a national leader in developing humane and progressive regulations and methods to deescalate and control crises without violence and with proven efficacy, as sited by the Federal Substance Abuse and Mental Health Services Model Programs.  In the early 1990’s, the NY State Mohawk Valley Psychiatric Center required that staff be trained in techniques to preempt and deescalate situations and thereby avoid restraint use.  Education helped to eliminate cruelty that violated human rights.  Training in strategies to reduce and eliminate these “barbaric” restraining practices is what has been cited as the turning stone of environmental and humane culture change in institutions. 

On August 4th, Assembly Bill 9986-A was delivered to Governor Pataki’s office. He has ten days—not including Sundays—to veto or sign the bills.  At this time, Governor Pataki’s office has not issued a public statement regarding the billsTo check status, citizens may call the New York’s Legislative Bill Status Hotline at (800) 342-9860 (Mon – Fri, 9am to 5pm.).

Several leaders of progressive mental health services from Oregon, Massachusetts, Washington D.C., and Nebraska have expressed surprise that this legislation was proposed in NY State. They have offered support for opposition to the bills and assurance that their states are continuing to work toward the elimination of restraint and seclusion. NY State advocates hope Governor Pataki will veto both bills.

Citizens may also contact The Mental Patients Liberation Alliance (The Alliance), “a self-help, mutual support, and human rights advocacy organization of, by, and for people who have received psychiatric treatment.”  The Alliance has influenced mental health decision-makers and the public for almost four decades while collaborating with other statewide human-interest organizations. Recently the organization met with Governor Pataki’s counsel in opposition to the bill.

The author was unable to acquire comments in support of the bill for this article.