Ricky Wyatt’s case against the mental health commissioner Stonewall Stickney revolutionized mental health care after its finalization in 2003. Wyatt was institutionalized at Bryce hospital because of his uncontrollable antics. His family decided to institutionalize him in the hospital even though he was not diagnosed with any mental disorder.
After a policy on cutting off the cigarette taxes was upheld in 1970, Bryce Hospital became underfunded and understaffed. Therefore, the tax cut forced the hospital to lay off 100 staff members who were actively involved in providing activities of Daily Lives (ADLs) to the involuntarily institutionalized patients (Harris, 1973). Thus, this situation rendered the hospital dysfunctional because one clinical therapist and some three staff would be forced to serve over 50 patients daily.
So, this understaffing and poor working conditions led to the violation of some ethical principles in ABA. This paper explores the significant issues in the case that violated ABA operational ethics. Also, disregard for treatment principles innate in the case are presented together with the implications of the final verdict on the ABA treatment in general.
Operational ethics violated Ricky Wyatt’s case
To begin with, Cooper, Heron & Heward (2010) delve into the ethics of practice in ABA. In his journal, he explains that the fundamental reason why therapists or any other persons involved in providing psychological support should practice ethically is to further the welfare of the client. Addidionally, practicing ethically involves maintaining the principles of operation which are: autonomy, non-maleficence, fidelity, and justice.
Moreover, the ethical considerations for Applied Behavior Analysts is that they should be capable of determining a morally acceptable course of action irrespective of financial or time pressures. So, Wyatt vs. Stickney’s case presented various violations of fundamental ABA operational ethics. According to Wyatt’s testimony in court, some employees used to force patients to wrestle, and they would gamble on the results.
Explanation
Some physicians also zonked patients with shock treatment with high doses of psychotics to keep them under control. He recounts how he slept on a wet floor in a dark room. These abuses became the order of the day such that journalists reported that this case resembled the situation to those in concentration camps during the world war.
Patients suffered behind locked gates as others succumbed to the isolation and were buried in the hospital cemetery. Although these statements could not be fully ratified, there were some facts into it (Belcher, 2016). Then, after the tax cut was made, the hospital with over 5000 patients only had 100 staff members to serve them. This obviously increased the patient’s workload.
One major issue presented in this case is the poor working ethics of the staff. Even with the increase in the workload, they were not justified to torture patients within their confinements. Instead of practicing non-maleficence, the health providers caused harm to those they were supposed to protect.
Treatment principles violated–Ricky Wyatt’s case
Bailey & Burch (2010) explain the competencies of a professional behavior analyst. Common ethics mentioned in the journal includes empathy and integrity. In this case, the administration of high doses of psychotic medicine did not reflect empathy. Therefore, this action did not maintain an adequate quality of service provision as required by the standards of operation.
Moreover, the administered medication could not reduce the impact of the disorder while improving the quality of life in that confinement (Bailey & Burch, 2010). The fact that some patients, such as Wyatt, were detained in the hospital without a formal diagnosis was also a violation of operational ethics. So, he should have been confined after a consensual medical diagnosis that proved that he was mentally ill and showed signs of danger to himself or others. Following this, it can be concluded that Wyatt was illegally institutionalized.
Implications of the Verdict on ABA–Ricky Wyatt’s case
Before the transformation brought by the verdict, mental health institutions in Alabama became dumping sites for people who were considered a problem to themselves and society. However, after Wyatt vs. Stickney’s case was adjourned after 33 years of legal deliberations. Similarly, Judge Myron Thompson closed the case with an agreement that all mental health institutions would follow the guidelines stipulated under the litigation offered in the case. The Wyatt vs. Stickney case timeline was as follows (Belcher, 2016).
Verdicts
· 1970- The case was filed in court as a lamentation from patients over poor services following the understaffing experienced at Bryce after the cigarette tax cut. · 1970- Judge Frank Johnson ruled that every patient had a right to receive proper medical care, and any inhumane treatment within the hospital walls were violating the law. This acknowledgment brought about the Wyatt standards that are operational to date.
· 1972- A deliberation meeting was held the entire year that led to the identification of 35 standards that included staffing, nutrition, safety, and other protection features.· 1974- A set of standards were created on the use of electroshock on patients in Alabama. Patients responding to treatment well would not be submitted to electroconvulsive therapy (ECT)
· 1988- The Fair Housing Amendments Act was enacted that stated the illegality in denying persons with disability housing.
· 2003- The case was finalized with the state required to adhere to the mentioned recommendations. The major emphasis was on the humane treatment of people who have mental illness across the country.
The Wyatt standards detailed regulations that guided mental institutions that operated under three fundamental bases. One was that mental institutions should ensure that they provide a humane psychological and physical environment to their patients. This was by eradicating torture of any kind and considering consensual rights that include the freedom to deny unnecessary treatment or procedures.Regulations
Freedom to refuse any physical restraints and isolation. Therefore, these regulations also proposed that all institutions should have adequate qualified staff able to handle the population pressure in an institution (Belcher, 2016). This would ensure that proper clothing, food, and exercise are guaranteed with consideration of individual faith and cultures.
Additionally, mental healthcare providers were mandated to provide individualized treatment plans that would ensure each patient receives personalized care that suits their needs. From this requirement, the consensual right became a part of a policy that would ensure patients are involved in critical decision-making that pertains to their treatment plans.
Conclusion–Ricky Wyatt’s case
Wyatt’s case had a profound effect on mental health regulations. So, after the cigarette tax was eliminated, mental institutions such as Bryce Hospital suffered from a lack of funding and staffing. This streamlined back to the patients denying them the right to access quality mental health care and treatment.
To a larger extent, the case presented some concerning violations of ethics in the mental health profession. So, with the therapist required to be considerate, empathetic, and just, the case brought out the torture mentally challenged patients experience in solitude.
In conclusion, through the unveiling of the injustices, certain regulations were enforced, which changed the mental health service provision. Also, together with other policies, the Wyatt standards came to pass to develop national standards for care and treatment of persons living with any kind of disability.
References
Bailey, J. and Burch, M. (2010). 25 essential Skills and Strategies for the Professional. London: Routledge.
Belcher, J, D. (2016). Wyatt v. Stickney. Retrieved from; http://encyclopediaofalabama.org/article/h-2375
Cooper, J., Heron, T., & Heward, W. (2014). Applied Behavior Analysis, Chapter 29. England: Pearson Education Ltd.
Harris, R. W. (1973). Implementing the Right to Treatment for Involuntarily Confined Mental Patients: Wyatt v. Stickney. NML Rev., 3, 338.