Psychiatric Hospital Patients Win Right to Fresh Air

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In an “important legislative victory” patients in psychiatric hospitals in Massachusetts now will be allowed “daily access to fresh air and the outdoors,” according to a press release from the Mental Health Legal Advisors Committee. Outgoing Governor Deval Patrick signed the new legislation into effect on his last day in office.

“I was pretty stunned,” said Jonathan Dosick in the press release. Dosick is an MIA Blogger who has written about his long campaign for the legislation. “It was a real nail biter in those last few days.”

“Although the right to daily time outdoors may seem trivial” when compared with other fundamental rights, stated the press release, “to those who have experienced life inside a psychiatric unit of a hospital or other inpatient facility, the promise of even temporary reprieve from their confines can have important implications for those persons’ mental health and recovery prospects.”

However, the press release stated, Dosick has concerns that the bill still “lacks robust mechanisms to ensure its proper enforcement.”

“Fresh Air Bill” Passed, Establishing Sixth Fundamental Right for DMH (Mental Health Legal Advisors Committee press release, February 5, 2015)

Mental Health Legal Advisors Committee website

See also:

Common Sense, Deferred: Lessons From the “Fresh Air” Fight, Part One (Mad In America, September 17, 2012)

Common Sense, Deferred: Lessons From the “Fresh Air” Fight, Part Two (Mad In America, October 28, 2012)

35 COMMENTS

  2. “However, the press release stated, Dosick has concerns that the bill still “lacks robust mechanisms to ensure its proper enforcement.” ”
    Ah, didn’t notice this at first. So it’s not even a real victory. It will be totally ignored anyway.

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  3. It is true that the bill, as passed, lacks robust mechanisms, yes. We have been steadfastly pushing for a bill that also includes rigorous enforcement of the entire “Fundamental Rights” law (which this bill did originally). Due to pressures from the hospital industry, and the (sadly, inevitable) compromises that are part of every piece of passed legislation, what we have is the right to fresh air in the language of the law. Is that ideal? No, not at all. However, given the extreme difficulty and effort needed to get the language through, it is a victory in the sense that the language is there, and will need to be posted. The issue is being TALKED ABOUT. AND, we are continuing to push a new bill that would create the robust enforcement mechanisms needed. That MUST be passed.

    In other words, I know it’s easy to dismiss this piece of news and be critical of those who have worked hard to pass the bill for compromising too much. I only hope that the core message – that access to fresh air and the outdoors is not a privilege, not a luxury and not to be tied in with “risk management” – stirs public knowledge, and that this victory, while arguably symbolic, can be built upon.

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    • Don’t get me wrong, my comments were not to criticize your efforts, on the contrary I appreciate everyone who fights a good fight for even the tiniest progress. It’s more an expression of extreme frustration that getting a law (with no efficient way to enforce it) saying that psych patients should get fresh air is considered a victory. I’m trying to stay optimistic but some things make me want to cry or grab a weapon.

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      • Thanks B, and apologies for that wording. I agree that it is frustrating that it takes so much time and effort to get anything done…it speaks to the corrupting influence of Big Hospital (and the legions of lobbyists for the psych industry, so powerful here) that small gains are so difficult. We need to be ever more vocal in demanding our humanity.

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        • No need to apologize, I know I sound kind of frustrated… Unfortunately we’re in a place where we have to fight for most obvious basic human rights and savour every inch we win.

          Sad 🙁 🙁 🙁

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  5. Back in the days when I was cycling in and out mental institutions I remember how precious was fresh air and sunshine to us that were denied access . I protested this 40 years ago in Reed Zone Center in Illinois by taking off all my clothes and standing close to the full length pane of thick glass or plastic so I could at least feel the warmth of the sun on my body. I did this more then once and was dragged off and locked in a room alone for hours . I guess it was more proof for the psychiatric authorities how truly insane I was . Comes to mind the cry “no justice no peace”.

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  6. Jonathan, I know how long and hard you have been fighting for this. It is at the very least a step forward (and it is insane that this could even be an issue), and you should be proud of this battle you have been fighting so tirelessly. Well done.

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    • Thank you Robert for your kind words and steadfast support. The outstanding testimony you wrote summed it up so well – reminding us of the age of “moral treatment” recognized fresh air and outdoor access as a cornerstone to recovery and health. And this was almost 200 years ago! It’s still astonishing that something so elemental and basic can be taken away based on diagnosis; it shows that the most basic aspects of humanity can be denied simply on a label. As Steve says below, even maximum-security prisoners and livestock has more rights in this regard!

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  7. While I think it is great that the psychiatric inmates have gotten this right back, I think the fact that you had to fight so hard for it and that it was a “nail biter at the end” goes to show how completely unhealthy and destructive our current paradigm of care has become. Even criminal prisoners in the US have a right to daily exposure to fresh air. And anyone with half a brain knows that sunlight and fresh air are nature’s best antidotes to depression. To think that anyone would have to fight for such an obvious right and benefit for people who have done nothing wrong just shows how far we have our collective heads up our butts when it comes to providing “care” for the “mentally ill.”

    —- Steve

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    • So true, I’m sitting here reading this now, in front of a light box, because I live in a cloudy part of the country. We do all need our Vitamin D, even those stigmatized with voted into existence disorders, who were given drugs that cause the symptoms of those disorders.

      Agents with anticholinergic properties (e.g. neuroleptics) may have additive effects when used in combination. Excessive parasympatholytic effects may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.

      The neuroleptic drugs do cause the symptoms of schizophrenia.

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      • Yes, very true. And hospitals are under mandates to change meds, even if there’s no real reason. There have also been some interesting studies about the effects of fluorescent lighting on one’s mental state. Fluorescents are a staple at most psych hospital units, yet they can cause disassociation and throw people’s circadian rhythms off severely.

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  9. Russerford here, commenting on my wife’s account since for some reason I keep getting “bounced” on my own.

    My first thought was “Kudos, Massachusetts and outgoing governor Deval Patrick!” One of the most egregious aspects of our daughter’s last lengthy psychiatric hospitalization was the lack of these two very basic therapeutic things: fresh air and sunshine. Isn’t it ironic that even convicted felons are provided with these, but psychiatric patients can be denied them?

    However, as others of you have noted, the article goes on to point out that the bill still “lacks robust mechanisms to ensure its proper enforcement.” And that’s a huge problem in this “gulag psychipelago” we live in! There seems to be no one in any kind of authority with the guts, the knowledge or the clout to do anything about the errors and abusive practices that abound. We found that out when we tried to bring the psychiatric unit in a local hospital under some corrective scrutiny through the NY State Office of Mental Health. They allowed the hospital to do their own internal review, and did nothing independently to expose the whitewash job.

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    • I understand your concerns. While getting the words in the law is a milestone, the lack of focus on enforcement continues to be pretty appalling. The original bill text contained language that would create such robust mechanisms, but it has been the first thing to go in committee hearings. I believe that besides public ignorance and discrimination, the fact that two major lobbying groups for hospitals are incredibly powerful and moneyed is an important part of why the fight was (is) so hard; also, the Dept. of Mental Health’s greatly diminished complaint review process prevents such violations from being taken seriously. I still hope that a continued groundswell of advocacy ensues, and perhaps the outspoken new AG here will take notice.

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  13. Yes, now reading the other comments above I also thank you, Jonathan, for your diligent efforts to bring this about. I certainly have my share of cynical and pessimistic moments in this fight, but we must press on! Here’s an excerpt from one of Winston Churchill’s famous speeches about another noble fight:

    “But we must learn to be equally good at what is short and sharp and what is long and tough. It is generally said that the British are often better at the last. They do not expect to move from crisis to crisis; they do not always expect that each day will bring up some noble chance of war; but when they very slowly make up their minds that the thing has to be done and the job put through and finished, then, even if it takes months – if it takes years – they do it.”

    And now let me take the liberty to slightly modify a following portion of that speech (modifications in brackets):

    “I am addressing myself to [my fellow freedom fighters against the Gulag Psychepelago] – surely from this period [ ] this is the lesson: never give in, never give in, never, never, never-in nothing, great or small, large or petty – never give in except to convictions of honour and good sense. Never yield to force; never yield to the apparently overwhelming might of the enemy.”

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  14. Jonathan, Congratulations! I don’t know if you knew about my efforts regarding Telephone Privacy in Massachusetts. We know the Five Fundamental Rights aren’t followed at all. All units break these laws regularly. Also, “sitters” break these laws as well unless the patient points out, “This is the law.” While fighting for telephone rights I was first told I didn’t have rights and that I was delusional. I finally won the case after about ten months fighting the state. The unit agreed to building soundproofing around one phone. Unfortunately, I believed they’d actually follow a court order. They didn’t. After a year I found out that they had made no moves to ensure patient privacy on the phone. I contacted the state again. It was getting too exhausting. The law is the law and if these “units” insist they are above it, they need to close down.

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    • Hi Julie:

      Thanks for your kind words and your advocacy! I read one of your books many years ago, before becoming an advocate, I think – one of the first exposes of psych units I read!

      I have found that of all the other Five Fundamental Rights, (arguably) the one that is most brazenly violated is phones. I have been in 5 hospital facilities and seen several more, and can’t recall ONE that fully respects the telephone right – “reasonable access,” with privacy. Congrats to you or speaking out loudly. I have seen or heard of phones in the middle of hallways, pay phones only without access to money to make calls, locked phone cubicles, surveillance of phone calls, etc. etc.

      In the years we have been working on the combined fresh air/rights enforcement bill, I’ve heard all manner of excuses for violating the right to communicate by phone: “If we let people use the phone, they’ll stay on for 5 hours”; “We can’t afford to create a private space for phones”; “private phone areas would be too claustrophobic,” and the ever-present “we shut the phones off during group times.” (As if attendance in groups trumps the right to communicate). The MA DMH introduced an electronic devices policy, which (in theory) would allow people to have cell phones, smart phones, etc., but I have major doubts as to how that is working. (Most cell phones have cameras, so are immediately confiscated). It’s an issue at group homes too.

      In addition to supporting the continuing bill that would finally put ‘teeth’ in the Six Fundamental Rights, I am hoping that legal action (as suggested above) can and will be pursued regarding this law – which is now 17 years old and not taken seriously.

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      • Does anyone here know if it is actually legal for a hospital to disallow all family and friend visitors? That’s what happened to me. My family was told they were not allowed to visit. And when some of my friends came to visit me, they were turned away. And this was at a regular ELCA Lutheran hospital, not a mental hospital.

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      • I never knew to whom I should speak. I tried complaining about abusive care but was told I would probably not find a lawyer because I am not rich. Every step of the way, the psychs tried to make a fool of me. In one facility I had to ask permission to make a call and the nurse stood by me the whole time and “commented” out loud on what I told my friend. If she didn’t like the content of my conversations, she’d click offf the phone. I found out that over half the patients on the unit had their phone conversations monitored in similar manner. They told me the following, “We are afraid that you will expose us.” I hope they made sure to brace themselves, because I haven’t stopped exposing them since.

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  15. For whatever reason, I missed the comments to this article all this time, so I apologize. I am awfully glad I found them. In the interim, I was quietly involved in a court case about a year ago in which a hospital illegally tried to acquire land by claiming it was an educational institution. The citizens found my blog and decided they did not want a kiddie prison on their land, so they investigated and noted that the hospital was doing it all illegally. I sent an affidavit and the case was thrown out even before it made it to court. There was no case, and the sale didn’t go through. All I can say is nyah nyah. However, I have been fighting for the rights of these patients all this time, and the patients didn’t get this. They thought the townspeople were “stigmatizing” them. Not true. The townspeople didn’t agree that young people should be treated with force. They agreed with me that kindness was a better approach.

    Thanks so much for continuing this thread because it restores my faith in humanity. Life it tough.

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