A recent audit by Michigan’s Office of the Auditor General has raised significant concerns regarding the protections for mental health patients in the state’s psychiatric facilities. This audit follows an incident involving an unannounced active shooter drill at Michigan’s only state psychiatric hospital for children, which provoked a lawmaker to call for the audit of the Office of Recipient Rights (ORR), the agency responsible for overseeing complaints and rights violations across Michigan’s mental health hospitals.
Key Findings of the Audit
The audit brings attention to several crucial inefficiencies within the ORR, indicating that a substantial number of patient complaints are not being handled swiftly or adequately. It specifically found that nearly 30% of complaints alleging abuse, neglect, serious injury, or death were not acted upon until 2 to 12 days after they had been filed. According to the state’s training guidelines, complaints should be addressed within 24 hours—a benchmark that the ORR clearly is failing to meet.
Moreover, over 10% of the complaints lacked a date stamp, making it impossible to ascertain whether the appropriate actions were taken in a timely manner. The audit also highlighted issues with video surveillance, revealing that cameras often weren’t functioning or were missing altogether in the state hospitals.
Inefficient Complaint Processing
A significant problem identified in the audit is the ORR’s inefficient complaint processing system. A staggering 70% of complaints are submitted via drop boxes located in state psychiatric hospitals, which are typically checked only twice a week. This delay results in potential risks to the well-being of patients, as timely responses to serious allegations are critical.
Although the Department of Health and Human Services (MDHHS) acknowledges the findings and the need for improvement, the absence of a national guideline for daily complaint reviews means that necessary changes may lag further.
Delay in Investigations
The audit emphasizes that the ORR must improve its timeliness in investigating complaints. Alarmingly, some investigations took more than a year to complete, even when the allegations turned out to be true. For example, one patient required surgery after swallowing construction hardware, yet the ORR delayed initiating their investigation. The audit uncovered delays in the initiation of investigations for over 30% of sampled complaints, emphasizing that a more expedited response could safeguard vulnerable patients.
Lack of Effective Monitoring Systems
Alongside the issues related to the speed of response, the audit pointed out that critical monitoring systems, such as video and audio surveillance, are not consistently applied across all hospitals. Although video surveillance is present in all state hospitals, the cameras frequently malfunctioned or recorded nothing at all. Consequently, crucial evidence that could assist in investigations often went missing.
MDHHS responded by asserting that reviewing the surveillance systems is not under their purview and landed the responsibility on external vendors. This stance raises troubling questions about accountability and oversight in managing patient rights and safety.
Conflict of Interest Concerns
Another concerning aspect brought forth by the audit is the potential for conflicts of interest within the ORR. The agency has been urged to bolster its monitoring of rights advisors’ independence, as they are responsible for both the investigations and the compliance with established protocols. The audit highlighted that there is currently no requirement for rights advisors to disclose potential conflicts. This lack of transparency could compromise the integrity of investigations and the protectiveness of patient rights if biases go unnoticed.
Patient Awareness and Communication Issues
The audit also points to deficiencies in how patients are informed about their rights. There were significant lapses in posting standardized signage regarding patients’ rights within state hospitals. In one instance, 83% of observed areas in a specific hospital lacked required information about patient rights and resources.
Efforts are needed to improve communication strategies to ensure that patients fully understand their rights and have access to the necessary resources to assert them when needed.
Response from the Michigan Department of Health and Human Services
The MDHHS has acknowledged these findings and expressed a commitment to improving the situation. The organization committed to addressing shortcomings in the complaints process, focusing on staff training, and looking into the allocation of additional resources to support the ORR more effectively. However, the MDHHS also pointed out that not all findings align with their operational protocol and indicated a desire for a collaborative approach to addressing these challenges.
Moving Forward: The Call for Legislative Action
With the audit shining a light on the existing issues, lawmakers, mental health advocates, and community stakeholders are now pushing for reforms and legislative actions. The objective is to enhance protections for patients in psychiatric hospitals and to ensure a more accountable and effective Office of Recipient Rights.
Legislators, including Michigan Sen. Michael Webber, have underscored the necessity for systemic improvement to better protect patients. They argue that such reforms are not merely beneficial but essential for the overall integrity of mental health services in Michigan.
Conclusion
The recent audit of Michigan’s mental health patient protections is a stark reminder of the systemic challenges faced by vulnerable individuals within psychiatric care. Despite current protocols, there is an evident gap in the timely handling of complaints, investigations into grievances, the use of surveillance systems, and the communication of rights to patients. While MDHHS has indicated a willingness to improve, continued pressure from the community and advocacy groups will be paramount in ensuring that these promised changes translate into meaningful reform. For families and advocates, these issues remain essential in the ongoing fight for the dignity and safety of mental health patients throughout Michigan.
