Improving Safety and Comfort During Med Passes and Mealtimes at Western State Hospital

Patients at Western State Hospital have raised ongoing concerns about the practice of locking individual rooms during medication passes and mealtimes. During these periods, patients must remain in shared common areas. In practice this often results in limited seating, mixing of patients at different levels of acuity, and situations that are especially difficult for certain individuals.

We appreciate the administration’s recent clarification of the policy. As stated in their response to the Citizens’ Council:

“Individuals being unable to access their bedrooms during specific treatment times have always been a part of WSH’s unit rules. The issue arose when it was identified that the admission units were following this policy while other units including extended care units were inconsistent in how the policy was being applied. Per the human rights regulations, program rules must be applied to ALL individuals the same regardless of which unit they are on. To ensure compliance with the regulations, units that were not applying the policy consistently were told that they needed to. As with every policy and rule at the facility there are exceptions to this. A provider may write an order stating that the individual can remain in their room or return to their room during or directly after they have received their treatment.”

We understand the need for consistent application of unit rules across the hospital and respect the effort to bring all units into alignment with Human Rights Regulations. At the same time, patients continue to experience concrete problems that affect both comfort and clinical stability.

One of the most serious concerns is the impact on patients who have histories of sexual trauma. During the lock-out periods these individuals are required to remain in the same confined spaces as patients who have documented histories of sexual predation. For someone with a trauma history, being unable to leave that environment and return to the relative safety of their own room can be profoundly distressing and retraumatizing. It can also increase overall tension on the unit and contribute to the very crises the hospital works to prevent.

Additional practical issues include insufficient chairs so that some patients must stand or sit on the floor, and the mixing of stable patients with those who are significantly more acute.

We believe these conditions can be improved while still meeting the hospital’s legitimate needs for consistency and safety. The Citizens’ Council respectfully asks the administration and Human Rights leadership to consider the following practical steps:

• Ensuring enough seating is available in every common area used during med passes and meals.

• Developing clear, trauma-informed guidance so that providers more readily write orders allowing patients with sexual trauma histories to return to their rooms when clinically appropriate, rather than remaining in spaces with individuals who have documented predatory or sexually aggressive histories.

• Exploring limited, supervised options for clinically stable patients to return to their rooms when appropriate.

• Looking for ways to reduce unnecessary mixing of widely different acuity levels during these periods.

We remain committed to working constructively with hospital leadership, the Human Rights Advocate, and the Local Human Rights Committee. Our shared goal is a safer and more therapeutic environment for everyone who lives and works here. Patients want to partner in finding practical solutions that support both operational consistency and the dignity and recovery of the people we serve.

The Citizens’ Council welcomes further discussion and is ready to help identify improvements that can be implemented thoughtfully.

Unite for Patients Rights

Western State Hospital