By: Haley Lehman, Alaska Beacon
The Alaska House of Representatives advanced a bill Wednesday that aims to address a lack of oversight for minors treated at psychiatric facilities in Alaska. The bill would mandate an annual report on conditions and treatment at such facilities from the state’s Health Department, as well as unannounced biannual inspections.
Rep. Maxine Dibert, D-Fairbanks and the bill’s sponsor, said the measure is a necessary step to increase accountability around the treatment of minors in psychiatric hospitals in the state, amid constituent concerns.
“These are not sweeping mandates, they are basic expectations of transparency, of communication and accountability of our youth here in Alaska,” she said on Wednesday.
The bill passed the House of Representatives with 37 yes votes. Three legislators were absent. It has been transmitted to the Senate for consideration.
The bill would also guarantee patients confidential telephone or video communication with a parent or guardian for two hours per week and require the Department of Health to notify a patient’s parent or legal guardian when seclusion or restraint is used within 72 hours.
The annual report would include information about the total uses of seclusion or restraint, findings of facility inspections and data on the number of minors who received residential care at psychiatric hospitals.
Dibert cited a 2004 investigation by the Disability Law Center of Alaska that found 261 episodes of seclusion and restraint over three months in psychiatric institutions, which the organization called “quite high.”
The United States Department of Justice issued a report in December 2022 that found that Alaskan youth are institutionalized in psychiatric hospitals and psychiatric residential treatment facilities at higher rates and for longer periods than minors in other states as a result of a lack of available and accessible community-based mental health services, violating the Americans with Disabilities Act.
Rep. Genevieve Mina, D-Anchorage and Chair of the House Health and Social Services Committee, voiced her support for the bill and drew attention to a finding by the DOJ that identified gaps in community-based services in Alaska.
Community-based services include home-based family treatment for early intervention services, intensive case management and crisis services, according to the DOJ.
“We have to face the reality that many of these kids are in these institutionalized settings because we have underinvested in our home and community based services in this broader continuum of care,” Mina said.
“The dearth of community-based services in Alaska is so pronounced and widespread that institutional placement has become, for many behavioral health service providers in the state, the default option to which they refer children with long-term behavioral health need,” DOJ investigators wrote in 2022.
According to the DOJ, more than 800 Alaskan children received behavioral health services in a psychiatric institution in 2020. Approximately a third of the patients were Alaska Native and parents reported to the DOJ concerns about separating their children from their culture while in residential treatment. In addition to four psychiatric residential treatment facilities in Alaska, the state sends children to 17 out of state psychiatric residential treatment facilities.
Rep. Justin Ruffridge, R-Soldotna, told legislators that the bill provides oversight and accountability that legislators are expected to institute.
The bill received support from the Alaska Federation of Natives, Lives in the Balance, a nonprofit that advocates for the fair treatment of children, Dot Lake Village, Citizens Commission on Human Rights, an organization that aims to eradicate abuse in mental health settings, and Aleutian Pribilof Islands Association.
The Department of Health estimated in a fiscal note that it would cost approximately $222,800 annually for a full-time nurse consultant to perform inspections, conduct interviews with patients and conduct investigations and for two nurse consultants to attend trauma informed care and cultural awareness training.
