Senate Finance Committee Hearing On The Abuse Of Seclusion & Restraints In Psychiatric Facilities

Posted on October 26, 1999

We commend Senator William Roth (R-DE) for his prompt action in convening a hearing of the Senate Finance Committee following the release of the General Accounting Office (GAO) report on October 1, 1999 on the improper use of restraints or seclusion in psychiatric facilities.

It has been one year since The Hartford Courant published its investigative series, inspired by reports from NAMI Connecticut families, which documented 142 deaths around the country from such abuse during a ten-year period. The Harvard Center for Risk Analysis further indicated that between 50 and 150 such deaths occur every year.

NAMI also has compiled Cries of Anguish; a summary of additional reports of abuse received since the Courant investigation-cited in the GAO Report-which includes over 40 incidents from 20 states. During one five month period, five deaths were reported-four of them of youths under the age of 18. And those are only the ones we know about.

Legislation has been introduced in Congress. After today, two Senate hearings will have been held. The Department of Health & Human Services has published regulations for Medicare and Medicaid funded hospitals and is in the process of developing regulations for residential treatment centers. In spite of HHS's regulatory initiatives, there still are no consistent national regulations governing restraint and seclusion use in all facilities providing psychiatric treatment. The GAO has confirmed what many of us already knew over a year ago.

Not only is the current system broken-but indeed, there is no system. Most importantly, no comprehensive reporting system exists. It is both a national disgrace and a national crisis. Literally, people are dying. Others are being physically injured. Others are being psychologically scarred for life.

People will not be fully protected unless Congress passes a law to end the current system of horrors. Regulations are not enough, because too often, they are too easily changed. The issue today is not whether Congress should act, but when? How many more people must die before Congress acts? We hope this hearing will be used as a foundation for decisive action in the weeks ahead. NAMI calls on Congress to mandate the reporting of all deaths and serious injuries to state based legal entities which can investigate the circumstances of such incidents. Further, consumer and family facility monitoring groups should be put in place.