Massachusetts Joint Committee on Mental Health and Substance Abuse

Representative Elizabeth A. Malia

House Chair

State House, Room 33

Senator Jennifer L. Flanagan

Senate Chair

State House, Room 520

September 23, 2009

Chairwoman Malia, Chairwoman Flanagan, and members of the Committee:

My name is Jonathan Dosick. I am a consumer advocate, and I am testifying on behalf of House Bill #3585, "An Act pertaining to people with mental illness in hospital emergency rooms". I urge the Committee to report this bill out favorably.

There has been some good progress made since the ‘original’ ER Rights bill was filed last session. An unprecedented coalition of consumers, advocates, and trade groups have sat down and discussed the vitally important need for fundamental change in Emergency Room settings. The Consensus Statement they agreed to was a good start - however, it’s just a start. This bill rightfully directs the ER Rights Working Group to continue their work, so hopefully more progress will be made.

Restraint and seclusion is now widely seen as a "treatment failure," and it’s been proven that not only doesn’t it work, it is often horrendously damaging both physically and mentally. It is the ultimate form of disempowerment and is totally contrary to the values of the recovery model.

The reason why this bill is important is that it creates transparency, which should ALWAYS be in effect. When established laws, such as Informed Consent and the Five Fundamental Rights, are routinely violated, it concerns me that a Consensus statement (even with correspondent regulations) is not even a law. Again, I realize that Emergency Rooms are overcrowded and very stressful for those working there - but this is no excuse for the violence of restraint and seclusion.

When the rule of law is not applied, violations ensue. We have seen this illustrated by the Informed Consent and Five Fundamental Rights laws, which are brazenly ignored all too often. It would be nice if, as the hospital lobbyists say, they can operate better with less regulations. But I don’t believe that many large institutions can be trusted to police themselves, especially when there’s relatively little awareness of the issues at hand. There needs to be accountability, and this bill provides it by requiring essential data on restraint and seclusion to be presented to the Committee. When this data becomes available, it opens doors to further negotiations and understanding by both sides. I believe that the stakes are too high not to continue the effort to end discrimination and the potential for abuse in Emergency Rooms. The fact that more people are turning to ERs because due to loss of primary care coverage intensifies the need.

As an advocate and consumer, I strongly urge the Committee to report House Bill #3585 out favorably. Thank you.