July 09, 2009

New Jersey Bans Smoking At State Psychiatric Facilities

Via If You're Going Through Hell Keep Going comes news that the State of New Jersey has decreed that patients--and presumably employees--will no longer be allowed to smoke on the grounds of its state psychiatric hospitals. It's a move that strikes me as unfair on a number of grounds and, if Washington State's experience with a similar ban at its state hospitals is any guide, it's a move that will eventually be reversed.

While I get the state's point that smoking isn't healthy for patients, for it to make the argument (and it is) about health improvement in a patient population it's already slamming with antipsychotics is assbackwards. Besides, most state hospitals I know of in the US are fairly restrictive on how long patients are allowed outside of their buildings (often patients are restricted to 30 minutes a day of outdoors time), so it's not like too, too many patients were outside blazing through a pack of Camels all day. I bet most patients were smoking perhaps a few cigarettes a day, particularly because state hospital patients are typically medicated to the gills and sleep a lot (at least in my experience). Add that to the fact that this represents one more freedom taken away from a group of people who've lost their freedom of movement, their freedom of association (their freedom to socialize with other patients in a manner of their choosing) and many of their rights to control what goes into their own bodies and I just get pissed off on their behalf.

The Nanny Statists behind this move are chasing a non-problem. Unless they've suddenly made Zyprexa safer.

IYGTHKG has plenty of similar thoughts on her post on the matter.

I wrote about Washington State's ban on smoking at state hospitals in 2007:

"[I]n 2004, Western State Hospital here in Washington State took away psych patients' rights to smoke cigarettes outdoors on their 30-minute a day breaks from the wards. The hospital's CEO told me it was for the patients' "own good." I told him that he was taking away one of the patients' few pleasures and that I considered it mean, given the fact that the patients are mostly schizophrenics who are so doped up that whatever visceral joy they get from smoking ought to be granted to them in the name of their psychological health."

The smoking ban was lifted in 2005.

Posted by Philip Dawdy at July 9, 2009 12:03 AM
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Comments

I don't smoke but when I was inpatient the smoke breaks were the one bright spot in an otherwise miserable day. All the patients knew when the smoke breaks were and we counted the minutes until we could go outside and just feel human for a moment.

It doesn't make any sense that they would be so worried about the effects of smoking when the food they serve is literally dripping in grease, no opportunities for exercise are offered, and people are half asleep on antipsychotics that cause obesity, hypertension, & diabetes. Maybe instead of forcing people to stop smoking they could start with offering healthy foods and opportunities for exercise.


The quality of life in a state psychiatric hospital is shit. And they are determined to make it even shittier for patients. Good job!

What are they going to threaten patients with now that they've taken away their smoke breaks? THat was always the big threat when I was in the hospital, "If you don't do a, b, or c then you can't go outside."

You asked about the staff who smoke. I suspect they will do what they do at every other hospital with a no smoking policy - they will violate the policy & go smoke in their cars in the parking lot.

Posted by: Lisa at July 9, 2009 12:49 AM

What a brilliant idea. One to make nutters go even crazier... yeah nice one state of Jersey/whatever

Posted by: Gledwood at July 9, 2009 02:40 AM

The law is intended for the health of people working in the hospital. If psych patients smoke who is going to complain and enforce the rule?
My prediction...
No one working in the hospital wants angry withdrawing-from-nicoteen psych patients. They will put the patients in an official smoking room where staff does not have to go in ( workplace safety rules), and volunteers (hospital staff who willingly smoke) will run the room.

Posted by: mark p.s.2 at July 9, 2009 05:45 AM

How ironic in a long challenged system: New Jersey claims that it is concerned about patient health at our state psychiatric hospitals yet it has recently cut the number of medical doctors at the same institutions.

Ancora, the state's largest psychiatric hospital, is the subject of a US Department of Justice investigation and http://www.nj.com/news/index.ssf/2009/05/greystone_park_psychiatric_hos.html">Greystone still can't get its act together despite 30 years of Doe v. Klein monitoring.

Half of the patients in New Jersey's state psychiatric hospitals remain trapped on Conditional Extension Pending Placement there for want of housing, services and supports in the community.

The state represents mental health consumers as being empowered and having choice yet one choice which would be afforded them in the community is denied.

Where New Jersey has achieved too little and promised so much for so long at our state psychiatric hospitals it now seeks to evidence change by imposing it on the backs of very patients it has served so poorly.

[New Jersey is far from being alone in achieving too little but representing too much; words are always easy. The tragedy is that the words are so often believed despite the grim reality.]

Posted by: Anonymous at July 9, 2009 06:09 AM

While I am no big fan of tobacco (I quit Sept 25 last year) I think the ban is ludicrous and I hope they recant.

Posted by: Allegra at July 9, 2009 08:04 AM

From what I've seen, withdrawing from nicotine can cause some serious weird interactions with meds, and/or psychotic breaks in the MI population. I am by no means pro-smoking (just the opposite, my parents' heavy smoking in enclosed spaces gave me terrible chronic bronchitis) but this is just wrong.

Posted by: kimbriel at July 9, 2009 08:52 AM

Dose that mean the patients and workers have to step off the property.
Where is the compassion in these hospitals?

http://smokersclubinc.com
http://pasan.thetruthisalie.com

Posted by: Thomas Laprade at July 9, 2009 11:05 AM

I've been in too many psych wards as a visitor and witnessed mayhem when smoke breaks were skipped or taken away.

I accompanied (was used as staff with the nurses station number in my cell phone, talk about liability)a group at Western State Hospital to the outside yard so they could get the smoke break in for the day and my daughter could play basketball--hell 15 minutes was all they were getting, and they got told "no smoke break, not enough staff" and I swear fist fights broke out, it was dicey in there.

Another Chantix syndrome will come out of these bans, and the patient will be blamed for their "illness" being the reason for increased psych "symptoms" or "thoughts of suicide" as a result of medications.

Then more meds will be added, to decrease agitation and attempt to cover up withdrawals, come on for the good of the patients, my ass!

ALL of the staff go out for smoke breaks too, my God coping in those places is hard enough, I think my kid was the only person in the entire ward/unit/floor who didn't smoke and they also used smoking as a ploy to get ppl to take meds and take away smoke breaks as med compliance coercion. Because my daughter didn't smoke they flat out took away her outside fresh air time until I told them the ACLU would hear about it.

Nanny states suck, just another injustice and smack in the face of the indignity people with mental health labels face every single day. Treated as if they are less than human, and frankly, I am sick of it.

Posted by: Stephany at July 9, 2009 11:08 AM

Nothing done at psychiatric hospitals would surprise me as they are state approved prisons for people who have had no trial and are deemed to have no rights to avoid cruel and unusual punishment because they are being treated, not punished.

When I was in the psych hospital, smoke breaks were one bright spot and when you're living on a locked ward with bars on the windows and no hope, with less civil rights than people in conventional prisons, fashioning maxi pads out of toilet paper and not brushing your teeth or using deodorant because neither toothbrush, toothpaste nor deodorant is provided, lying around in a hospital gown twitching from the drugs, legally forced away from your job, your friends, your pets, legally billed 1000g a day with no consent, smoking is a welcome break.

Don't even ask how you get an orderly to give you a smoke. Physical abuse, like Shari Roan says, doesn't matter when it happens to one labeled as severely mentally ill, as those so labeled are sub human so it just can't be abuse to harm them, after all they don't feel and if their "thought disorders" trouble us non smi, we are entitled to beat the muther f*ck out of them.

Really convicted criminals have a right to smoke and to go outside, breath fresh air, but not those labeled as "mentally ill." Sh*t

Posted by: Sally at July 9, 2009 12:54 PM

Intereting. I don't smoke, but when I was inpatient at a private university hospital, there were no smoke breaks; anyone who smoked was required to use a nicotine patch during daylight hours.

Thoughts?

Posted by: sI at July 9, 2009 04:42 PM

West Seattle Psych announced today that they are going non-smoking in August

Posted by: Geronimo at July 9, 2009 09:13 PM

Banning smoking altogether is going to be a serious problem for the staff. Using cigarettes as leverage is a common and probably the most effective way to enforce compliance.

At our local bin, patients have to move off the grounds to smoke. Unfortunately, that puts them on the sidewalk by a pretty busy road. It's pretty embarrassing to be standing there in your hospital jammies taking a puff but, hey, smoking is about the only thing to live for when you're incarcerated. I quit three months ago but I'd start again in an instant if I ended up back on the ward.

Posted by: Francesca Allan at July 10, 2009 09:02 AM

The latest from one of the two New Jersey state psychiatric hospitals where a smoking ban has been instituted, Ancora Psychiatric Hospital worker charged with sexual assault of patient.

Posted by: Anonymous at July 11, 2009 09:34 AM

I don't smoke. I was a week at Sainte Anne's Mental Hospital in Paris after a mother of an episode ending in delirium.

The patients smoked in the TV room, some of the staff smoked in their staff room. There was actual laughter in the cafeteria sometimes.

The Washington State psych ward, the only other hospital I've been in, we were treated more inhumanely, and that was 1992, not that long ago - yeah, they could smoke outside in a caged area. In France, once fairly sane, we got a free pass for a half hour walk on the street or staff would walk with us. Much better.

I firmly disagree with the smoking ban, but what can we do? I wonder if even outside the US smoking bans are being enforced.

Posted by: A Elisabeth at July 11, 2009 08:21 PM

Haven't you all seen One Flew Over the Cuckoo's Nest? ("I want MY cigarettes Nurse Ratchet!")

As an intern in a residential crisis center, I saw that smoke breaks were tremendously helpful. It was the one time out of the day when folks felt like regular people. I got to know people better during 10 minute smoke breaks than I did in groups, and that's a fact.

Posted by: Ben at July 12, 2009 05:43 AM

They are doing the same thing here in the UK which has always struck me as extremely illiberal but then our present government never tires of telling us how much we should eat, drink, how many times we should brush our teeth, wipe our arses and how to tie our shoe laces so no surprise there.


Is it true that they have banned smoking on death row on health grounds or is this an urban legend?

Posted by: e at July 12, 2009 05:54 AM

Either make cigarettes officially illegal and stop benefiting from the "vice taxes", or stop the ever-increasing piles of restrictions, rules and bylaws that makes the use of this LEGAL PRODUCT effectively impossible.

Posted by: beth at July 14, 2009 11:57 AM

They have banned smoking on all hospital campuses here in Michigan. What a great way to further drive people off the deep end. I think that mental health patients deserve to have a break and if that break included smoking a cigarette, than so be it. The drugs cause far more harm in my opinion.

Posted by: Shannon at July 14, 2009 02:44 PM
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