Washington Post Photo
A week ago, The Washington Post published a front-page story about Alison Hymes, a self-described psychiatric survivor, long-time Virginia mental health advocate and person living with mental illness.
Reporter Annys Shin’s story was headlined:
SHE FOUGHT FOR PATIENTS’ RIGHTS, THEN HER’S WERE STRIPPED AWAY.
I met Ms. Hymes when we both were appointed to a task force appointed by the Chief Justice of the Virginia Supreme Court to draft new language for civil involuntary commitment criteria.
From the start, Ms. Hymes and I bumped heads.
Ms. Hymes was dead set again changing the state’s involuntary criteria, which required that a person pose an “imminent danger” to him/her self or others. Because of what I had experienced with my son (being turned away from a Virginia hospital emergency room because my son was not considered dangerous enough), I felt the exact opposite.
Our task force sessions were combative and often unpleasant — no that is too mild of a word. They were downright painful. Ms. Hymes and another consumer on the task force complained that the deck had been stacked against them and they made it clear to everyone that they had no interest in compromise or being friendly to those who disagreed with them. Only in retrospect can I understand why they felt defensive. Given that the shootings on Virginia Tech campus happened shortly after our group started meeting, the Virginia legislature was going to change the commitment standard regardless of what our group recommended. The deck was, indeed, stacked against the status quo.
After our task force completed its job, I lost touch with Ms. Hymes until Shin contacted me several months ago and told me that Ms. Hymes had been involuntarily hospitalized. I was sorry to hear this. Based on how well she was during our task force meetings, I’d assumed that Ms. Hymes was doing fine and had gone on with her life. When I learned otherwise, I hoped she was getting the meaningful care that she deserved.
Shin told me that Mind Freedom had launched a “Free Alison” campaign on the Internet. That wording made it sound as if Ms. Hymes had suffered the same horrific fate of thousands of others with mental illness during the 1960s when there were few safeguards and patients were warehoused. Given Ms. Hymes’ familiarity with the commitment process and Ms. Hymes many connections in mental health circles both in Virginia and the nation, I didn’t think that she — of all people — would end up being railroaded into a hospital.
I was eager to read Shin’s story. I have admired her reporting and felt confident that she would get to the bottom of what had happened. But I was horrified when I picked up my paper and saw the headline: “SHE FOUGHT FOR PATIENTS’ RIGHTS, THEN HER’S WERE STRIPPED AWAY.”
I sent Shin an email complaint – although I knew that she had nothing to do with writing it.
I explained that Ms. Hymes’ rights had not been “stripped away” simply because she had been involuntarily committed. Virginia requires a hearing before an administrative law judge before someone can be involuntarily hospitalized. An attorney is appointed to represent the person who faces commitment and an independent examiner also interviews the potential patient and makes a recommendation to the judge. Once someone is committed, there are legal procedures in place where they can fight their hospitalization if they feel it is unjustified. Virginia also has a protection and advocacy agency whose job it is to make certain no one is being held unfairly in a hospital. All of these protections were adopted to protect patients from past abuses.
Ms. Hymes was quoted in the story saying that our task force’s recommendation that “imminent danger” be abandoned in favor of “substantial likelihood of danger” had made it easier for her to be forced into a hospital.. No one can deny that this lower threshold made it easier for Ms. Hymes to be hospitalized.
But the implication that she and others are being railroaded at an alarming rate because of the new criteria simply isn’t true. While the results of a current review haven’t been made public, past studies have shown no substantial increase in forced commitments since the language was changed.
What’s sad about all of this is that the sensational Post headline put the focus of Shin’s story on the wrong issue. The fact that Ms. Hymes was involuntarily committed isn’t the problem. Getting her into the hospital, in fact, more than likely protected her from a worse fate. It was her inability to get out of the hospital after she was committed that is the real tragedy here.
Despite her connections and importance in the mental health community, Alison Hymes found herself being warehoused in the state mental hospital and that is when her civil rights were violated. According to Shin’s story, hospital authorities only decided to discharge Ms. Hymes after Shin showed up with her to watch her evaluation hearing. The threat of having a reporter write about Ms. Hymes’ plight appears to be what caused hospital officials to find somewhere in the community where she could live safely. That’s wrong.
Shin’s story makes it clear that Hymes was being warehoused because there was no place in Virginia where she could get the wrap-around services that she needed in the community. Sadly, this should not be a surprise to anyone who is familiar with Virginia’s underfunded mental health system. Before Virginia Inspector General Douglas Bevelacqua resigned in protest ( because his reports were being watered down,) he sounded an alarm in 2012 about a lack of suitable transitional housing. He warned that 70 patients in state mental hospitals were ready to be discharged but couldn’t be released because there was no place for them to go. Like Alison Hymes, they were being warehoused — not out of spite but because of a lack of services.
This bottleneck is not only harmful to individuals in the hospital but it wastes tax dollars. According to Bevelacqua, the average cost of keeping a patient in a state mental hospital is $590 per day or $215,000 per year. The average cost of supporting that same patient in a community setting is about $120 per day or about $44,000 per year. It doesn’t take a math wizard to see the savings. Taxpayers are shelling out $15 million for services that could be obtained for $3.3 million, or wasting $12 million.
Shin’s story ends with Ms. Hymes finally getting into a community group home where she will hopefully get the assistance that she needs to transition back to her condo where she can continue on a path to recovery and, I assume, once again become a vocal advocate. She will have much, about which, to complain.
Sadly, the Post did both Reporter Shin and Ms. Hymes a real disservice by putting a headline on the story that focused on the involuntary commitment criteria – a red herring – and by pandering to fear mongering from the past rather than on a lack of decent community based case.
(Unfortunately, I was unable to reprint Shin’s story at the end of this blog. But you can read it here.)
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