The CMS seclusion and restraint rule places consumers at undue risk.
Timothy Souders, a 21-year-old man who had bipolar disorder, died
needlessly last year in prison. Specifically, he died of dehydration
after being placed in seclusion and in restraints up to 17 hours each
day for four days (see a recent “60 Minutes” segment on Timothy’s
death).
That anyone is still placed unnecessarily in seclusion and restraints
is a travesty. Unfortunately, however, the federal Centers for Medicare
and Medicaid Services (CMS) made it easier for hospitals to use the
traumatic and non-therapeutic practice of seclusion and restraint
through a new regulation issued in December. This rule involves
significant and unwarranted changes to an interim final rule issued in
1999 and dramatically undermines protections for mental health
consumers in very vulnerable situations.
A Dangerous Setback
Mental Health America is extremely concerned that these changes
constitute a significant step backward from the growing consensus in
the mental health community that every effort should be made to prevent
the use of seclusion and restraint—practices that should only be used
as a very last resort in emergency situations. (Read Mental Health
America’s position statement on the use of seclusion and
restraints.) Mental Health America is currently meeting with
members of Congress to alert them to our concerns and is working with
several of them to develop strategies to alleviate this dramatic
setback. You, too, can help by expressing your alarm at CMS’
unwarranted revisions to Congress.
How the Final and Interim Rules Differ
In general, the new requirements regarding monitoring of consumers in
seclusion or restraint have been lessened with great discretion left to
the hospitals. The final rule also sets troubling time limits on
when a seclusion or restraint related death must be reported, and CMS
failed to require that debriefing sessions be conducted following each
use of seclusion or restraint. In addition, requirements that
staff receive training on the proper use of seclusion and restraint and
alternative methods of behavior management have been weakened.
More information and the final CMS regulation is availble here.
Take Action Now
Alert your members of Congress to the disturbing changes included in
CMS’ final rule on the use of seclusion and restraint in hospital
settings and urge them to direct CMS to restore the patient protections
included in the 1999 interim final rule.
http://takeaction.mentalhealthamerica.net/site/Advocacy?pagename=homepage&page=SplashPage&id=113&autologin=true
\