Fairness During Group Games Treatment Facilities

 Fairness 

When playing group games in mental health and developmental disabilities treatment programs, the games are often improper or unfair. 

This is not as big an issue at the State Hospitals for adults, but it is more of an issue at day programs and private short-term care hospitals for adults. For children and adolescents, fairness is a vicious problem across the continuum of care.  

First off, staff should never be allowed to compete against or alongside service recipients, and staff vs. service recipient tournaments should be prohibited. It can be a safety issue when playing physical games, such as kickball, as a bad kick or throw from staff could cause injury to the service recipient. When staff participate in cognitive games, it can imbalance the ability level of each team due to cognitive deficits as a result of developmental disorders, mental illness, or the medications used to treat them.  

Staff should give everyone an equal opportunity to win. For instance, staff should not help one service recipient find a number on a bingo board and not provide the same assistance to others who ask for it. 

Teams should be divided equally by the number of players and ability levels, and never based on clinical criteria such as commitment status, diagnosis, or level of functioning. When this happens, it perpetuates stigma throughout the system of care that individuals with more severe diagnoses are not capable of winning a game, especially when medication impacts their participation. 

It is fitting that unfair games can contribute to resentment and deep-seated anger towards the entire field of psychiatry, which can cause other problems, such as high restraint and seclusion rates (for children, adolescents, and adults) and low treatment retention rates (especially for adults), among many problems that could potentially result from these feelings. 

First off, we need to assess the root cause of the problems associated with fairness. Then we have to fool around with solutions that might resolve the problems. After that, we need to create regulations that support those solutions.  

The State and the federal government need to design financial incentives for having fair games in treatment facilities. We need to research how unfair games impact the treatment of different types of service recipients.  A lot of service recipients will not make complaints about this because they think it is “too trivial” a complaint. Service recipients should have the right to fair games. It is just not therapeutic to have unfair games in the mental health and developmental disabilities treatment programs.

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