Group sues over forced medication of patients at New Jersey psychiatric hospitals

TRENTON — New Jersey psychiatric hospitals regularly medicate patients against their will, and state law prevents an outside review of medication practices, according to a federal lawsuit filed by a patient advocacy group.

Disability Rights New Jersey seeks a judicial review of all involuntary medication decisions, a practice currently required in 29 states, including Connecticut and New York.

"We're not talking about emergencies here," said W. Emmett Dwyer, the litigation director for Disability Rights New Jersey, a federally funded agency that protects the rights of the disabled. "We're talking about ongoing treatment of people. We are not talking about people who are wild or out of control and need to be sedated."

In New Jersey, prison inmates have more right to refuse medication than in state psychiatric facilities, Dwyer said.

Ellen Lovejoy, a spokeswoman for the state Department of Human Services, said in an e-mail response to the lawsuit, "It would not be appropriate for the department to discuss specific pending or ongoing litigation.

"However, in general, it is the mission and obligation of the department to provide recovery-oriented treatment while ensuring the protection of patients' civil rights and the safety of all patients and staff."

The powerful drugs prescribed for patients in psychiatric hospitals are often needed to treat diseases like schizophrenia. But the side effects of such medications are often severe, and can include liver damage, seizures, diabetes and high blood pressure. Patients often become lethargic after taking such medicines, and some advocates have accused state hospital officials of drugging patients so that they can be more easily controlled.

There are about 1,800 patients in the state's five psychiatric hospitals, and about 1,000 more in private mental health facilities, according to the lawsuit filed Tuesday.

Patients in state facilities who have not been found to be legally incompetent are allowed to refuse any dose of medication prescribed by doctors.

But repeated refusals lead to consultation with the patient's treatment team. The treatment team includes a physician, psychiatrist, nurse, psychologist and social worker.


If the team shares the doctor's view that the patient must take the medication, the patient has the right to seek the opinion of a second psychiatrist. The hospital's medical director then makes the final determination about whether the patient must take the drugs.


The patient does have representation: Two full-time staffers serve as client service representatives, and a third full-time person is on site as a consumer representative paid by Collaborative Support Programs, a consumer agency. These staffers are expected to keep patients informed that they can seek the opinion of a second psychiatrist.


However, Dwyer of the advocacy group said that although patients are permitted to seek a second opinion about their medication, it very rarely happens. He said patients often agree to take medications they do not want because they believe they otherwise will not be released from the hospital.


By contrast, in Connecticut a patient who refuses medication is entitled to a review by a second psychiatrist, as well as a hearing before a probate court judge. The patient is entitled to representation during the hearing and also has the right to question witnesses.


Should the judge decide that the patient must receive the medication, he or she writes an order that expires after 120 days, specifying the type of drugs the patient must take, and the exact dosage. At the end of that time period, the state must prove to the judge that the medication is working and that the patient has shown improvement, or the order will not be renewed.