A system for patients' rights advocacy in state psychiatric inpatient facilities in Maryland

A patients' rights advocacy system was developed in 1986 by the Maryland Department of Health and Mental Hygiene to serve patients hospitalized in 12 state facilities. The system includes a four-level appeal program that attempts to resolve grievances through mediation between patients and state staff and a legal assistance program operated by attorneys under state contract. Data from fiscal year 1990 indicate that issues related to treatment, to seclusion and restraint, and to admission, discharge, and transfer generated the most complaints. The majority of complaints were resolved without legal intervention at the first stage of the appeal program, usually in a meeting between a rights adviser, the patient, and the patient's primary physician.