The Complaint and Grievance Regulations of the Massachusetts Department of Mental Health

The lives of people with mental handicaps who reside in facilities opera ed or funded by the state are generally characterized by a sense of powerlessness, dependence, and a lack of dignity. This is especially so for the thousands of people who are institutionalized, although it is also true for the many more who depend on the Department of Mental Health for other forms of treatment, habilitation, and support services. These characteristics arise in great part as a result of a system which assumes it knows what is in the best interest of those who suffer from disabilities and consequently is always doing something to or for people. Rarely are there opportunities for persons with handicaps to in dependently initiate activities, to question the ap propriateness of decisions, or to demand accountability from those who manage or work within that system. Thus virtually all decisionmaking forums such as judicial or administrative hearings are invoked by men tal health or retardation professionals seeking, among other things, authority to involuntarily confine, to limit independence through guardianship or conservator ship, to determine treatment/habilitation objectives in in dividual service plans, or to assess charges for care. There is one exception to this pervasive pattern. Client grievance procedures are the sole mechanism available to consumers to challenge the actions of those who are employed to assist them. Unlike certain ap pellate avenues which are often complex and limited to a particular substantive issue, a complaint process can be an effective tool for consumers to challenge any situa tion that they find offensive. By establishing a process whereby people with disabilities can compel a review of an institutional employee's action or decision, this pro cedure offers a unique opportunity to reverse the tradi