Thursday, October 11, 2007

Illegal hospitalizations endanger patients

From the Israeli paper Haaretz, some strange events in the Israeli psychiatric care system.

Dr. Eli Griner has seen enough. Griner, the head psychiatrist for the Northern District in the Ministry of Health, recently alerted the ministry's director general, Prof. Avi Yisraeli, to the issue of illegal involuntary hospitalizations of dangerous patients at the Mizra state psychiatric hospital in Acre.

In an unusually sharply-worded letter to Yisraeli, Griner said these hospitalizations endanger the patients and medical staff at the hospital as well as the general public.

"What more needs to happen for the ministry under your control to step in and put a halt to this blatant disregard for the law?" wrote Dr. Griner.

In a case mentioned by Dr. Griner in his letter, a dangerous psychiatric patient from the high-security ward at Sha'ar Menashe Mental Health Center in Hadera, where dangerous psychiatric patients from throughout the country are hospitalized, was transferred to a closed ward at Mizra in March. The transfer was approved by both hospital's managements, but they did not obtain the district psychiatrist's approval as required by law.

In August, the patient assaulted another patient on the ward, who required stitches in his head as a result. The dangerous patient was returned to Sha'ar Menashe after the incident. In its report on the attack, the ministry's legal department expressed "wonder that both hospitals did not see fit to at least inform the district psychiatrist of the transfer...."

A Haaretz investigation uncovered several additional cases in which the welfare of helpless psychiatric patients and the general public were jeopardized. The investigation was based on dozens of documents and internal, confidential reports.

One of these involved the suicide, on hospital grounds, of a double-leg amputee who had been hospitalized at Mizra for 32 years. The patient sneaked out of the building in the middle of the night without being noticed, got out of his wheelchair and laid under a parked bus in the hospital lot. In the morning, he was run over and killed by the bus.

The internal investigation committee found no fault with the patient's treatment, but the report nevertheless raises many questions about the care of psychiatric patients with physical disabilities. The investigation revealed that for years the patient had applied to be admitted into a group home, which rejected him because of his disability.

A ministry report cited shortages of basic foods at Mizra, including meat, cheeses and powdered milk.

According to a statement by a Health Ministry spokeswoman, most of the charges "were examined and found to be baseless and fallacious, and based on biased personal interpretation that does not match the interpretation of the ministry's legal department." Certain issues were still being examined and have been passed on to the relevant offices within the department. The spokeswoman did not indicate exactly what was determined to be "baseless" and "fallacious," by whom and according to what standard..

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