Friday, January 16, 2009

Incongruous headline of the day: do you think the headline to this story really gives the most accurate short version of the story?

And to give you a taste of the linked story, here's an excerpt:

"In a psychiatric seclusion unit, a patient complained to inspectors that she had urinated on sheets in her room because she couldn't communicate her need for a bathroom. The patient's medical record said she refused offers to go to the bathroom, which were made every two hours. Inspectors tested the audiovisual equipment that monitored patients in seclusion and found the video worked but the sound did not. When loose wires were found disconnected from the intercom, staff was unaware how long the equipment had been nonoperational, the report says"

Besides the obvious, you may wish to note the Orwelian overtones of referring to a room in which one is locked, alone, for an extended period of time, in which room one cannot be heard, but only watched at the convenience of those outside, as a "seclusion unit." The only thing that differentiates a psychiatric seclusion unit from the solitary confinement type of torture is careful and caring oversight of the inmates. UCI personell didn't even provide enough oversight to save the patient above from having to urinate on her sheets. In other words, it appears that UCI did not provide careful and caring oversight. Therefore ... well, the conclusion is obvious.

It's good, in my opinion, that Medicare is looking into these things. Once again, the University of California has been accepting payment for services (adequate monitoring of solitary patients in this case), and then apparently not providing the service. It's a pattern.

However, the question almost asks itself: where is law enforcement? In this particular case, the failure to provide the services which differentiate between "psychiatric seclusion unit" and "solitary confinement" suggest that abuse of a dependent person (the psychiatric patient in this case) may have occurred. What would it take to make UC administrators and staff actually perform the monitoring that they are paid to do? Would it take a death? In December 2005, a psychiatric patient with a known suicidal history was was monitored so ineffectively as an inpatient at UC Irvine that he managed to kill himself. So, it appears that death due to inadequate monitoring is not enough to justify adequate monitoring going forward, nor even to preclude disconnection of basic monitoring equipment. There may be a pattern here beyond financial irregularities, and that possible pattern should be investigated beyond the financial aspects.

No comments: