It seems a simple request: let mental-health patients get outdoors from time to time. But up to 20 of Massachusetts’s 65 psychiatric hospitals are expected to ask to be excused from new rules guaranteeing patients the right to fresh air, largely because they can’t deliver it.
The new rules were released last week by the Massachusetts Department of Mental Health, to implement a law passed last year. They grant the psychiatric patients of any facility “reasonable daily access to the outdoors”—which could be any outside area, such as a roof, courtyard, or porch. It can be even be fenced, if safety is a concern.
But some hospitals, particularly those in urban areas, just don’t have such a space available. Massachusetts General Hospital in Boston, for instance, is surrounded by busy roads and plans to apply for an exception, reports Stat. If a hospital can’t provide safe outdoor access, it can appeal for a waiver, but must convince the state that it has considered all reasonable measures, including spending on renovations and expansion.
The new rules list outdoor access as one of six basic rights for mental-health patients. Others include the right to visitors, uncensored mail, and private telephone calls. Every facility must have a human-rights officer and a human-rights committee of at least five people overseeing how the institution provides these.
However, while Massachusetts has a procedure (pdf) for patients to complain about ill-treatment, the new rules don’t specify any penalty for hospitals that fail to grant these rights. Jonathan Dosick, a mental-health advocate who campaigned for the legislation, pointed out (pdf) the lack of enforcement mechanisms when the bill became law last year. Another bill, proposing an administrative review for hospitals that don’t comply, has been filed but not passed; Denise Provost, the state legislator who filed it, told Quartz that, if re-elected, she intends to refile it next January.
At least 17 other US states have similar laws regarding outdoor access, according to the Mental Health Legal Advisors Committee, which advocated for the law. But it has taken several years of campaigning to get Massachusetts to pass the bill, because some hospitals were worried about what it would mean for safety and staffing.