Privacy for the institutionalized mentally ill: Are court-ordered standards effective?

Abstract

During the past decade the courts have taken an increasingly active rule in shaping the physical facilities that house environmentally captive individuals. Perhaps the most influential of these cases was Wyatt v. Stickney (1972), which has been cited as a basis for standards promulgated by other courts (e.g., Davis v. Hubbard, 1980), for model standards (Staff, 1977), and for changes made by administrators fearing litigation (Sommer & Kroll, 1979). Despite this widespread acceptance, there was no apparent empirical basis for, or validation of, the standards. The purpose of the present study was to assess the validity of the behavioral assumptions underlying the Wyatt standards regarding physical changes intended to ensure patient privacy. Patient perceptions of privacy were examined on two units in a facility that met the standards mandated in Wyatt. The results demonstrated that although some of the court's assumptions were valid, several were not, and that overall the standards in this influential case do not ensure patient privacy for the institutionalized mentally ill. The implications of these findings are discussed.

On the Status and Contribution of Westin's and Altman's Theories of Privacy

“…In 92% of the articles, privacy had an environmental component. Similarly, research on privacy has spanned a range of settings, including residences and residential facilities, offices and factories, schools, hospitals, prisons, outdoor/wilderness areas, space stations, banks, and pharmacy counters (e.g., Beardsley, Johnson, & Wise, 1977; Churchman & Herbert, 1978; Hammitt, 1994; Harrison, Sommer, Struthers, & Hoyt, 1986; O'Reilly & Sales, 1987; Prather, 1972; and chapters 10, 18, 19, and 21 in Stokols & Altman, 1987).…”

Mental health law and mental health care: Introduction.

“…It was concerned with empirically testing whether laws were achieving their explicit and implicit goals. Thus, when a federal court ordered that mentally ill persons residing in state hospitals be accorded their right to privacy, utilitariandriven research was able to demonstrate that the institutional changes aimed at fblfilling the court order did not achieve their goal (O'Reilly & Sales, 1987& Sales, , 1986. Thus, when a federal court ordered that mentally ill persons residing in state hospitals be accorded their right to privacy, utilitariandriven research was able to demonstrate that the institutional changes aimed at fblfilling the court order did not achieve their goal (O'Reilly & Sales, 1987& Sales, , 1986.…”

“…This approach to law and behavioral (and social) science interactions asserts that almost all laws are based upon behavioral, social, and economic assumptions the validity of which can be empirically determined (Sales, 1983; Sales & Hafemeister, 1985; Shuman, 1984). Thus, when a federal court ordered that mentally ill persons residing in state hospitals be accorded their right to privacy, utilitarian-driven research was able to demonstrate that the institutional changes aimed at fulfilling the court order did not achieve their goal (O'Reilly & Sales, 1987, 1986). The findings of this type of research can be used to argue for changes in the law or in its implementation.…”