LOS ANGELES - TelAve -- As Mental Health Awareness Month draws to a close this May, Citizens Commission on Human Rights (CCHR) International, a mental health industry watchdog, examined a month's worth of distressing reports detailing patient abuse. These accounts included incidents of children subjected to assault under care, investigations into both state and for-profit psychiatric hospitals, and the pursuit of criminal charges against the most egregious offenders. Yet, despite the gravity of these events, such instances of abuse and patient deaths resulting from negligence remain largely overlooked during Mental Health Awareness Month. It has only been through the diligent scrutiny of media investigations, lawsuits, and pressure from advocacy groups, including CCHR, that the pervasive issue of psychiatric abuse is brought to light, revealing its status as a silent epidemic.

This month, the American Psychiatric Association's (APA) annual meeting, held in New York, discussed sexual violence in psychiatric inpatient units. One speaker remarked, "The hallmark of sexual violence is betrayal of trust." However, as a seminar attendee pointed out, only patient-on-patient violence was addressed, and not the betrayal of a treating psychiatrist, therapist, or hospital staff member sexually abusing patients in their care. Patients are also betrayed when they are violently restrained and told this is to "protect" them.

During the APA convention, news broke of a therapist charged with multiple offenses relating to the sexual assault of a 14-year-old-boy, while being treated at a youth facility in Pennsylvania, according to state police.[1]

Shortly before the APA meetings began, a $50 million lawsuit was filed alleging staff at a Michigan psychiatric hospital encouraged a 15-year-old girl to attack a 10-year-old boy, while both were patients there. Surveillance video also showed hospital staff members stomping on the 10-year-old boy's fingers as he stuck them under a locked door.[2]

Two days later, a New Hampshire jury awarded $38 million to a man who exposed a pattern of mistreatment, including physical violence, sexual assault, and prolonged isolation at another youth development center. The lawsuit sparked over 1,100 similar claims spanning six decades, with survivors alleging they were abused by state employees.[3]

Media also reported allegations of abuse, falsification of records, lack of care and "overmedication" at a for-profit psychiatric hospital in North Carolina. A doctor and 13 former staff members, interviewed by NC Health News, indicated that staff relied on drugs rather than treatment. From January 2019 to September 2023, police responded to assault calls 116 times and sexual assault allegations 129 times.[4]

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The Salt Lake Tribune detailed how Utah brought "one of the strictest sanctions possible" from Utah authorities against another for-profit psychiatric hospital, due to a litany of issues, including failure to report sexual abuse allegations and improper medication practices. The sanction—short of closure—mandates the facility hire an independent monitor for 40 hours a week for a year.[5] Federal regulators also threatened to terminate Medicare funding to the facility.[6]

CCHR says the meager penalties imposed for patient abuse in mental health facilities serve only to perpetuate further misconduct. Such leniency sends a dangerous message, suggesting that staff can act with impunity under the guise of mental health care. According to CCHR, there is an urgent need for tougher repercussions to deter coercive practices.

Psychiatric Services reports that the use of seclusion and mechanical restraints in U.S. psychiatric hospitals is rife, despite the traumatizing effects and risk for lethality associated with these practices.[7] However, CCHR says the problem is global.

In May, media in Switzerland reported that "the line between help and deprivation of liberty is in danger of becoming blurred," as the use of restraints in psychiatric hospitals was exposed—some patients were strapped to their beds for six days, another "locked in an isolation room or tied naked to the mattress." As reported, "What sounds like a horror film actually happened in two psychiatric clinics in Switzerland." Over 18,300 people were forcibly admitted to a psychiatric facility in Switzerland in 2022—one in four against their will. Of 36,119 coercive measures, one in 10 involved restraints.[8]

In May, the Royal Australian & New Zealand College of Psychiatrists (RANZCP) held its 60th Annual Congress, themed "Excellence and Empathy, Knowledge and Kindness."[9] Yet, in 2021-2022, there were 16,966 restraint incidents in acute mental health services in public hospitals alone, and a 36% increase in the rate of physical restraint applied to children and adolescents since 2017/18.[10] According to a British Journal of Psychiatry Open study, of 166,102 public mental health hospital admissions over 5 years in New South Wales, Australia, 54% included at least one day of involuntary care.[11]

A recent UK report found that over 2,000 mental health inpatients were subjected to restrictive interventions in one month alone.[12] Reported this month, more than 15,000 people are estimated to have died between March 2022 and March 2023, while being cared for by community mental health teams.[13]

Laws allow mental health practices to be forced on individuals, which is hostile to the intentions of the World Health Organization (WHO) and United Nations Office of the High Commissioner for Human Rights (OHCHR) Guideline on Mental Health, Human Rights and Legislation. The guideline condemns coercive practices, which include involuntary hospitalization, forced drugging and electroconvulsive therapy (ECT), the use of seclusion, and physical, chemical and mechanical restraint, as these "violate the right to be protected from torture or cruel, inhumane and degrading treatment…."[14]

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CCHR says that psychiatric abuse and coercion are consistently overlooked during Mental Health Month. They advocate for the implementation of an annual report, akin to the one published in the UK on restraints and seclusion, called "Out-of-sight—who cares?" which transparently discloses instances of abuse. Such a requirement would serve to shed light on these critical issues and ensure accountability within the mental health care system.

About CCHR: CCHR was founded in 1969 by the Church of Scientology and the late Dr. Thomas Szasz, Professor of Psychiatry, State University of New York Upstate Medical University. It has helped achieve over 190 laws that protect patients from abuse.

Sources:

[1] Judy D.J. Ellich, "Child therapist charged with **** of a boy while working at Somerset County Youth Aid Home," The Daily American, 2 May 2024

[2] www.wxyz.com/news/lawsuit-claims-psych-hospital-staff-encouraged-young-patient-to-attack-another; www.detroitnews.com/story/news/local/michigan/2024/05/02/second-lawsuit-october-fight-at-juvenile-center-hawthorn-center-walter-reuther-psychiatric-hospital/73543117007/

[3] apnews.com/article/youth-detention-center-trial-new-hampshire-1cacb2f57f4eccaeb776e712d016cd8e; indepthnh.org/2023/08/25/ydc-victims-and-supporters-rally-at-state-house-seeking-federal-investigation/

[4] www.northcarolinahealthnews.org/2024/05/06/former-employees-say-short-staffed-nc-psych-hospital-rife-with-violence-abuse/

[5] www.sltrib.com/news/health/2024/03/20/why-utah-brought-one-strictest/

[6] carolinapublicpress.org/60141/nc-psych-hospital-failed-to-provide-safe-and-therapeutic-environment-feds-say/

[7] ps.psychiatryonline.org/doi/10.1176/appi.ps.202100538

[8] www.bluewin.ch/fr/infos/faits-divers/ils-racontent-leur-enfer-en-hopital-psychiatrique-2188714.html

[9] www.ranzcp.org/events-learning/ranzcp-2024-congress

[10] cchr.org.au/restraint-is-criminal

[11] www.cambridge.org/core/journals/bjpsych-open/article/factors-associated-with-involuntary-mental-healthcare-in-new-south-wales-australia/622E67D17D22C8F9CAC4677A01897209

[12] www.cqc.org.uk/publications/themes-care/restraint-segregation-seclusion-review-progress-report-december-2021

[13] www.independent.co.uk/news/health/nhs-mental-health-deaths-leak-b2526944.html

[14] www.ohchr.org/sites/default/files/documents/publications/WHO-OHCHR-Mental-health-human-rights-and-legislation_web.pdf