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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
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“Wasted writing. A, incontinent ward.”
Byberry
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“Missing plaster”
Byberry
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“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” Begins
2003: 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
