No one tracks such cases. However, through interviews and records from advocacy groups and state and federal agencies, the AP found at least a dozen patients who were held in seclusion for months or years at a time.
"I think it's just a wink and a nod and some people are looking the other way," said Charlie McCarthy, an advocate with Disability Rights Montana, who nevertheless said he understands what drives hospitals to work around the law.
"Everybody's frustrated with what do you do with somebody like this? The patient has rights, but the other patients have rights to be safe and free from abuse."
In Virginia, one man was locked in a three-room suite for 15 years and another patient was held in a similar setup for five years. Connecticut and Florida have paid millions over allegations that they tethered patients to furniture for years.
Federal law requires that seclusion or restraints - including drugs - be used on patients covered by Medicare or Medicaid only in emergencies to protect other patients and staff. Such measures can be used for more than 24 hours only if a physician deems it necessary, and only if a doctor updates that assessment daily.
Moreover, the US Supreme Court has ruled it unconstitutional to restrain or isolate patients for extended periods.
The laws and court rulings don't cap the consecutive days a patient can be isolated or restrained, though, so hospitals can hold a patient indefinitely by simply signing off on it every 24 hours.
The Supreme Court also has ruled that hospitals must treat people who are involuntarily committed. So Stuart Grassian, a psychiatrist who has studied the effects of solitary confinement on prisoners, and others question whether outliers are being held legally.
