Alaska Mental Health Trust Authority needs to catch up to best practices

The Alaska Mental Health Trust Authority is proposing to amend its by-laws. The public is encouraged to comment on the proposed changes prior to or at the Oct. 27 Special Full Board of Trustee meeting in Anchorage.


In our opinion, the Trust Authority by-laws should be amended to require the establishment of a standing committee that would catalogue the rights of the disabled and the number and type of complaints. Without the basic knowledge of beneficiaries rights and complaints, the Trust Authority will find it difficult to fund the advancement of rights for the disabled to best practice. The Trust committee should also be required to actively work to help improve rights for the disabled (Trust beneficiaries).

The Trust Authority is a state corporation with approximately $500 million in cash assets and $1 million acres of land, the profits from the assets approximately $30 million annually is designated to aid approximately 50,000 Trust Authority beneficiaries. Thirty million is a significant amount of money to help bring Alaska in line with best treatment practices for the disabled.

The Trust Authority beneficiaries fall into five main categories: individuals with a mental illness, individuals with developmental disabilities, individuals with brain injuries, persons with Alzheimer’s and persons who have alcoholism and other substance abuse disorders. A common thread is individuals needing assistance from the state because of their disability.

Improving the rights for the disabled in Alaska to at least best practice in other states would save lives by reducing suicides, recidivism and poor treatment outcomes. From the point of being picked up by the police and provided forced treatment in a psychiatric facility or unit, up to 47 percent of the patients “reported experiencing fear, helplessness or horror in response to these events,” as reported by Dr. Karen J. Cusack and others in “Trauma within the psychiatric setting: A preliminary empirical report.”

Alaska is about 20 years behind best practice when it comes to protecting the disabled. The Alaska government has never produced a grievance procedure and appeal process requirements specifically designed for individuals with a cognitive disability: The due process for disabled patient complaints and appeals in locked facilities is too long. The Alaska government does not adequately require that assistance is provided for the disabled when they are filing a complaint. AS47.30.847 only applies to some facilities. The law does not state when the patient advocates must be available.

There is a clear unavoidable tension between providers of services for the disabled seeking convenience/ economics and rights for the disabled which can manifest into patient abuse. All the more reason for the Trust Authority to establish a standing committee that will keep track of the number and type of complaints filed by Trust beneficiaries and work to improve the basic rights for Trust beneficiaries.

State-run Alaska Psychiatric Institute over 10 years ago had a 10-bed forensic unit — it still does. Overcrowding in the API forensic unit meant that in the past API management dumped criminals in with voluntary patients for evaluation, etc.

Alaska psychiatric institutions and units do not have a requirement to recognize and treat institutional trauma and that causes damage to the patients.

With little or no state oversight, staff in psychiatric institutions has removed rights from patients for minor infractions of hospital rules.

There is no standard amount of time that psychiatric patients in Alaska in locked institutions can go outdoors.

Psychiatric hospital patient policies are not readily available to patients and guardians in written form or on the computer.

Every improvement for the disabled mentioned was being done in other states 20 years ago — just not in Alaska even today.

• Faith Myers and Dorrance Collins are mental health advocates. They reside in Anchorage.


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