The Family Partners

The Family Partners

Volunteer Family Monitor Programat Trenton Psychiatric Hospital

State Hospitals

Trenton (1848 - )

Greystone (1876 - )

Marlboro (1931 – 1999)

Ancora (1955 - )

Hagedorn ( 1977 - 2012)

Hospitals: One Minute History (Osborn, 2009)

1700s: Chains, cellars, prisons 1773: Eastern Lunatic Asylum (first mental hospital) 1790s: Moral treatment: Rush, Pinel, Tuke 1841: Kirkbride at PA Hospital for Insane 1848: Dix and NJ Asylum

1890s Moral treatment Cust .care “Mental Hygiene”Asylums Institutions

1920s ECT, hydrotherapy, insulin therapy, lobotomies, exodontia

1950s: Thorazine, medical model, milieu therapy 1960s: Deinstitutionalization 1970s: Lawsuits 1980s: Psychosocial model

Asylum: “Exceptionalism” (Frank & Glied, 2006)

Institution: Bedlam 1945

Byberry

“Neglect – even in progressive States. This picture was taken in an eastern hospital.”

Byberry

“Incontinent ward. A big Phila. State Hosp. 1945”

Byberry

“Man in restraints, B, violent ward. Phila. State Hosp.

Byberry

Click icon to add picture

“Wasted writing. A, incontinent ward.”

Byberry

Click icon to add picture

“Missing plaster”

Byberry

Click icon to add picture

“Day room scene, B, violent ward. Phila. State Hosp.”

Ten years later…

“…the animals of nearby piggeries were better housed, fed, and treated than many of the patients on their wards.”

--Albert Deutsch, testifying to U.S. Senate, 1955

Legal Matters: Big themes

Civil commitment

Right to treatment

Jackson v. Indiana (1972) Wyatt v. Stickley (1972) Doe v. Klein (1979)

Right to refuse treatment

Community integration

Olmstead v. L.C. (1999) NJPA v Davy (2005)

NJPA v. Davy (2005)

“…Defendant has egregiously misused CEPP status to retain staggering numbers of individuals in locked and dangerous facilities when they have a right to reside in and receive mental health services in the community...“

"CEPP patients residing on overcrowded and understaffed wards are routinely subject to abuse and neglect...

"... very limited therapy is offered in state psychiatric hospitals, even for conditions for which therapy, and not medication, is the recommended treatment..."

"... the Defendant has flagrantly failed to minimize the restrictions on the liberty of the individuals on CEPP status, as required by fundamental tenets of due process and human liberty."

CEPP

http://www.drnj.org/litigation.htm

State Hospitals

Trenton (1848 - )

Greystone (1876 - )

Marlboro (1931 – 1999)

Ancora (1955 - )

Hagedorn ( 1977 - 2012)

Greystone: Monitors (1979-2009) Doe v. Klein (1979)

2008: U.S. DOJ Ancora

Investigation about civil rights violations

“…patients at Ancora suffer an undue risk of harm, stemming from the facility's failure to treat aggressive and self-abusive behavior and its failure to implement systems to protect patients from harm.”

1996

Family members shall be actively encouraged to participate in various hospital advisory committees (e.g., grounds inspection, human rights, monitoring, boards). Each hospital shall develop orientation opportunitiesto help families participate effectively on internal committees (e.g.,Training, buddy systems).

2003: “Transformation” Begins2003: New Freedom Commission

“Transformation”

2003: New Freedom Commission

2003: National Consensus Statement

“Transformation”

2003: New Freedom Commission

2003: National Consensus Statement

“Transformation”

2003: New Freedom Commission

2003: National Consensus Statement

2005:Federal Action Agenda

“Transformation”

2003: New Freedom Commission

2003: National Consensus Statement

2005:Federal Action Agenda

2006:NJ Transformation Statement

NJ Transformation Statement (Martone, 2006)

“…ensure that consumers and families receive a system of recovery-oriented services ...”

“… our system embraces evidenced-based and promising practices that promote recovery and wellness across our entire spectrum of hospital-based and community-based services.”

Recovery-oriented Services

Illness Management and Recovery (IMR)

Integrated Dual Disorder Treatment (IDDT)

Assertive Community Treatment (PACT)

Family Psychoeducation

Supportive Employment

Supportive Housing

BH: Risk vs. Service Intensity (Beacon Health Strategies, 2012)

Office of State Hospital Management

Trenton Psychiatric Hospital

Monitoring

TRENTON PSYCHIATRIC HOSPITAL FAMILY MONITORS PROGRAM

Call for Volunteers

Program Trenton Psychiatric Hospital (TPH) Family Monitors Program. Description A volunteer visiting program to observe, inspect, review, and report

to management on conditions and programs within TPH’s facilities. Purpose To support and advocate for TPH patients, families, and staff.

Program Features

Visits~1 x month60-90 minutesEscorted. Scheduled but unannouncedSubmit evaluations

Team meetings (?)DiscussionsPresentationsTeam-building

Program Benefits

Know the system

Work for improvement

Learn the practices

Support patients and staff

Help the management

Lead for change

Process

Express interest

Interview

Paperwork (and fingerprinting)

Health check

Orientation

Visit