|
Vermont bans
routine shackling
(August/September
2006 Issue)
By Nan Shnitzler
The dormant issue of Vermont's mental health patients being shackled
for transport awoke last summer when a father published photographs
of his 11-year-old autistic son entering a Brattleboro treatment
facility in handcuffs and leg irons. The father had been available
to drive his son, but because the admission was considered involuntary,
the local sheriff's department stepped in.
"When the photographs appeared on the front pages of the state's
dailies, parents, the Vermont Association for Mental Health and
my agency decided not to let it go," says Larry Lewack, executive
director of NAMI Vermont.
As a result, the governor signed a bill, effective July 1, ending
the routine use of mechanical restraints during transport of mental
health patients (and pregnant inmates) in state custody. The law
amends existing statutes to require written justification when such
restraints are used.
The problem, Lewack says, is that the default policy for both key
agencies, the Department of Children and Families and the Health
Department's Division of Mental Health, assumes the highest level
of danger and flight. The state contracts with sheriffs' departments,
the only round-the-clock option, to provide secure transport and
their default was placing the passenger in mechanical restraints
in the back of a squad car.
"By defaulting to a high level of restraint, there was this dynamic
of using a blunt instrument when tweezers would do," Lewack says.
"By doing this, we were shortchanging patients and risking permanent
trauma in people, the vast majority of whom did not need that level
of restraint."
Even before this legislation was introduced, state officials were
working to instate policies to curb the routine use of restraints
without the force of law, says Rep. Ann D. Pugh (D-Chittenden) on
the Human Services Committee and a faculty member at University
of Vermont's Department of Social Work.
"Some might say the law reinforces what was policy," Pugh says.
The bill passed with tri-partisan support and sailed through both
Houses without debate.
The first thing the agencies did, says Charles Biss, MSW, child
and family unit director for the Division of Mental Health, was
to provide two sets of polyurethane humane restraints to each of
13 sheriffs' departments in the state. Then, officials looked at
developing an alternative transport system that involves caseworkers,
family members and private transportation services. Out of about
600 juvenile inpatient admissions over the last two years, approximately
80 went involuntarily and only about half of those needed secure
transport, Biss says. The agencies are also looking at alternatives
to sheriffs' departments to provide secure transport. "We're changing
the whole complexion of the way we transport," Biss says. Lewack
commends the policy improvements but says that mental health advocates
feared policies would not have the same staying power as legislation.
He is pleased that the law requires the agencies to document and
report to the legislature on the number, method and location of
all mental health transports. In addition, the law requires representatives
from the departments of health, corrections and justice to come
up with strategies to reduce the frequency and necessity of transports
using mechanical restraints. A written report is due Jan. 15, 2007.
|
