Psychiatric hospital wards in Israel all share "a threatening atmosphere and an aura of fear" that deters patients from filing complaints, a Health Ministry survey reveals.
The survey, taken between 2002 and 2003 in 17 psychiatric hospitals and psychiatric wards in general hospitals around the country, found that when complaints are filed, they are not always reported to the hospital management, even when some of the complaints have to do with serious incidents of improper behavior by medical or nursing staff.
The survey found that psychiatric patients also suffer from poor medical care, especially in dental care, gynecology, and nursing. They also suffer other abuses like physical and verbal violence by nursing staff and other patients, frequent thefts, widespread use of drugs in wards, sexual abuse, unjustified restraint and illegal threats to restrain, restriction of movement and threats of transfer to a closed ward.
The survey is the most comprehensive ever taken here and checked the norms of behavior of medical and nursing staff toward the 4,600 psychiatric patients hospitalized in Israel, as well as other conditions in the wards.
The survey was initiated following two cases about a year-and-a-half ago where nurses at the Abarbanel Mental Health Center in Bat Yam used serious physical violence against patients, took advantage of patients financially, and changed dosage of medicine distributed to patients as part of a dispute among the nurses.
The survey was carried out using questionnaires and interviews with managers, employees, patients and their families. It found hospital wards where 12 patients were kept in one room, wards where patients take showers only three times a week, and wards where patients have no permanent bed or locker to store their belongings.
Some wards had no rooms for family visits, no smoking section - so smoking was common throughout the ward - and no ways to give patients privacy. The results of the survey were presented to Health Minister Dan Naveh and to the director-general of the ministry Avi Yisraeli.
Yet the results presented to Naveh and Yisraeli were only the overall results, while the findings for each of the institutions are being withheld even from the ministry, despite the fact that some of the findings are of a serious nature. The hospitals by law are under the supervision of the ministry and some of them, like Abarbanel, are even owned by the state.
The specific results are being withheld even from the head of the psychiatric health services at the Health Ministry, Alexander Greenshpon. The situation came about after the ministry caved in to demands by hospital managements and by the medical labor organizations which demanded that the results not be published.
The survey also examined the medical care psychiatric patients were being given to treat physical ailments, following serious reports received at the Health Ministry in recent years of inadequate treatment.
It said: "The transfer of patients to general hospitals or infirmaries to receive treatment entailed much grief for the patients and their families. Patients, their families and sometimes even the staff attest to the fact that medical care for physical problems is incomplete, lacking and is often given with the aim of `getting rid of the patient.'"
The survey said many hospitals did report "an attitude of respect, compassion and caring by the staff toward the patients," and "no forceful behavior toward helpless patients was found." However, six hospitals reported cases of verbal violence by staff toward patients, with one case of a staff member having been fired for an incident.
The Health Ministry doesn't know at which hospitals the incidents took place, and is precluded from taking corrective measures, despite being responsible for the well being of the patients.