Investigation Reveals Patients Deprived of All Outdoor Access at Majority of NYC-Run Psychiatric Hospitals

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Most H+H hospitals deny patients receiving psychiatric treatment—including both children and adults—any access to the outdoors regardless of their clinical presentation or length of stay.


New York, NY—Mental Hygiene Legal Services (MHLS) and Disability Rights Advocates (DRA) have released a report titled “Denial of Fresh Air Access for Psychiatric Patients: A Report on NYC H+H Hospitals.” This report outlines findings from a months-long investigation into the denial of fresh air and outdoor access to individuals receiving psychiatric treatment in hospitals operated by NYC Health and Hospitals (H+H). The findings are stark—the majority of H+H hospitals continuously deprive patients of all access to fresh air and the outdoors, regardless of their circumstances or the length of their confinement. The investigation revealed the ongoing hardship and distress experienced by individuals subjected to uninterrupted indoor confinement, often for months at a time, while receiving inpatient mental health care in city-run hospitals.  Read the full report with legal analysis and recommendations for each of the eleven H+H Hospitals.

During Mental Health Awareness Month, MHLS and DRA call on H+H and the Adams administration to ensure patients receiving treatment in New York City’s psychiatric units are provided with regular outdoor access—similar to that routinely provided to others confined in city institutions, such as jail inmates. As the report details, some of H+H’s own written policies recognize “the therapeutic and healing benefits of fresh outdoor air,” and the “significant positive impact on the health and wellness of [] patients.” Nonetheless, most H+H hospitals deny patients receiving psychiatric treatment—including both children and adults—any access to the outdoors regardless of their clinical presentation or length of stay.

Patients interviewed by MHLS during the investigation widely reported the profound negative impact of this deprivation on their lives. At Bellevue Hospital, which operates eleven units, including three adolescent units, patients pleaded to go outside. One patient held at Bellevue for over a year, said “I live here in this bed.” A young boy described himself “an outdoors kid” who would want to go outside “as much as I humanly possibly can.” An adult patient reported, “after a while of being here, access [to the outdoors] becomes a need rather than a want.” A forensic patient, when asked about going outside, replied, “you mean like in prison?” From his past incarcerations, he knew that prison inmates are routinely permitted to go outside, even as hospital patients are not.

Photo by Giorgio Trovato on Unsplash

These patients’ experiences are unfortunately not unique. Bellevue, which provides no outdoor access to any of its adult or adolescent patients receiving psychiatric treatment (as many as 316 patients at any time), is joined by six other H+H hospitals who deny all their adult patients receiving psychiatric treatment access to the outdoors. The wholescale deprivation spans twenty-seven separate H+H units, three of which treat adolescents, for a total of nearly 800 licensed beds.

“Imagine going to a New York City hospital to get help for depression and learning that you can only receive inpatient treatment if you spend your entire hospitalization inside without any access to fresh air, nature, or the outdoors,” said Leonard Simmons, Principal Attorney at MHLS. “That is the reality in the majority of H+H hospitals. Ironically, if the person committed a crime and were in jail or prison, they would instead be guaranteed the right to regular outdoor access within days.”

“Individuals should not be excluded from access to the outdoors and fresh air simply because of their mental health disability,” said Erin Gallagher, Senior Staff Attorney at DRA. “Permitting patients to languish in locked units for months without stepping foot outdoors violates their legally protected rights and is unacceptable.”

H+H cannot continue its practice of denying fresh air and outdoor access to patients receiving psychiatric treatment. It is imperative that H+H implement and enforce policies that protect the fresh air rights of all these patients in their care, whether the patient’s hospital stay lasts two weeks or one year.

Mental Hygiene Legal Services (MHLS) – The Mental Hygiene Legal Service is one of the oldest legal advocacy programs in the U.S. for people with mental disabilities. Since its creation by statute in 1964, MHLS has served as the watchdog of the rights of people in New York who are hospitalized due to mental illness, as well as those with developmental disabilities. MHLS’s practice includes statutory and constitutional litigation, class actions and writs of habeas corpus in State and Federal Court. The agency has brought and continues to bring significant litigation on behalf of both individual clients and classes.

Disability Rights Advocates (DRA) – With offices in California and New York, Disability Rights Advocates is the leading national nonprofit disability rights legal center. Its mission is to advance equal rights and opportunity for people with all types of disabilities nationwide. DRA represents people with all types of disabilities in complex, system-changing, class action cases. Thanks to DRA’s precedent-setting work, people with disabilities across the country have dramatically improved access to education, health care, employment, transportation, disaster preparedness planning, voting, and housing. For more information, visit www.dralegal.org.

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