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Ask the Mental Health Expert Archives 2001-2004

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Abuse on Mental Patients

Q. Why is the abuse that occurs in psychiatric wards and in hospitals kept so secret? Why are those of us who have suffered such abuses ostracized further for speaking up about it? I really want to know because the mental health system castrates its own efforts as a direct result of these traumas it inflicts upon its patients. I have suffered severe physical and mental abuse guised as treatment. Internally I languish from these abuses and I also rage. No one cares it happens and it only worsens my problems. Why can't the mental health system be responsible for its actions?

A. It sounds like you have been through some terrible experiences in your contact with the mental health system--and for that, I can only express my sorrow and disappointment. Anyone who has been through such bad experiences would, understandably, feel a sense of rage. That said, it is hard to respond to your questions without knowing what, precisely, you are considering abuse, or how this was disguised as treatment. It is certainly no secret that sexual abuse of patients occurs at the hands of health care workers, including physicians--and not just in mental health settings. The American Psychiatric Association has addressed this in a strong public statement, which you can find at http://www.apa.org/.

The statement reads, in part: "When complaints of sexual contact come to APA's attention, a thorough investigation follows, usually lasting at least two years to allow adequate time for the process and for appeals. If an APA member psychiatrist is found guilty of sexual misconduct with a patient, the psychiatrist is suspended or expelled from membership. If APA suspends or expels a member, this is always reported in the APA's member newspaper, Psychiatric News and in the District Branch newsletter or other usual means of communication with the local membership; suspension and expulsion are reported to the Federal Government's National Practitioner Data Bank, which is an extensive listing of disciplinary actions taken against American physicians.

"State licensing boards consult the data bank before renewing a physician's license, as do hospitals before granting privileges. Attorneys may also consult the data bank, as may the APA and other medical specialty societies. The APA suspends or expels an average of 12 members per year for various forms of patient exploitation - most of them sexual." This website document also tells the public how they can report any such abuse.

In addition to the APA, others in the profession have been concerned with how psychiatric inpatients are treated. You may be interested in an article by SB Smith, entitled "Restraints: retraumatization for rape victims?", in the Journal of Psychosocial Nursing & Mental Health Services, July, 1995. This article explores the experiences of patients who have felt re-traumatized by being placed in restraints during psychiatric hospitalization. Of course, this does not mean that every restraint constitutes abuse--in some cases, physical restraint may be necessary to prevent a patient from harming him/herself or others--but that doesn't mean it is an easy thing for the patient.

If you feel that your traumatic experience has not found a voice that the mental health community is hearing, I would urge you to contact the National Alliance for the Mentally Ill (NAMI) at 800-950-6264. They will help you find ways of advocating for your own rights, and those of others. I hope you can bring some good out of the experiences you have had.

January, 2001

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