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.