People with disabilities faced forced confinement in many situations and are rapidly filling nursing homes
The Civil Rights Division of the US Department of Justice has threatened to sue the state of New Hampshire where people are allegedly facing forced confinement in nursing homes. These are people with mental illness labels who are are medically able to live in the community. If true, the state is violating a federal law that says people with disabilities must be housed in the least restrictive environment possible. (The Americans with Disabilities Act and the U.S. Supreme Court’s Olmstead decision.)
No fair, say the state attorney general and health and human services commissioner. We’re working to eliminate forced confinement. We have a 10-year plan.
Forced confinement in a medical facility of a person with no medical need to be there, who can live in the community, while you work on a 10-year plan to get him out, is not justice delayed or justice denied. I call it kidnapping.
There are complexities with the statement “reducing forced confinement saves money.”
Forced confinement is also a foolish waste of the taxpayers’ money since community-based treatment is so much cheaper, about 1/3 the cost. But saving money is not the most important reason to reduce forced confinement of people who can live in less restrictive settings.
The economic argument against forced confinemnt does not persuade administrators and policy makers. Nursing home, hospital, and jail administrators say reducing forced confinement in their institutions does NOT save money unless you close a whole wing, and permanently reduce the facility’s capacity. Why make a financial argument to finance experts, who won’t listen because you’re not a finance expert?
They have a financial answer to your financial argument, and their financial expertise trumps yours, they believe. Empty beds cost a facility money, unless enough are empty to allow the facility to close a whole wing, and reduce the facility’s capacity permanently, administrators say. They also argue that hospitals and jails need to be ready if large groups of admissions come all at once.
When the NH consumer leadership argued that voluntary crisis respite centers are cheaper than forced confinement in the NH Acute Psychiatric Hospital, the administrators said that it wasn’t enough people to save money.
The moral and legal argument for reducing forced confinement is more convincing
The biggest truth about forced confinement that it’s definitely illegal. Advocates fought hard for the Americans with Disabilities Act and the Supreme Court’s Olmstead decision, which requires that people with disabilites be housed in the least restrictive environment possible. Nothing in the law says “least restrictive environment the bureaucracy finds convenient.”
Forced confinement makes people more disabled and dependent. It cuts them off from family, friends, community, and the chance for a normal, fulfilled life. Forced confinement is immoral whether it’s expedient for administrators and taxpayers or not.
by Ken Braiterman