Restraint
There are also serious questions concerning the right of Tangram to force any brain-injured adult to be held against his or her will. Tangram's brochure states that only patients who are "not a danger to self and/or others" are admitted for treatment.
Yet according to Tangram's patient consent forms, Tangram reserves the right to "hold clients on the premises of Tangram by any reasonable means and/or for a reasonable time period although said holding and/or restraint may be against the expressed desire of client."
Texas attorney Martin Cirkiel, who specializes in health fraud cases, reviewed the consent forms from Tangram. "A competent adult could consent to just about anything. The issue here is can a brain injured person really give informed consent. This kind of fraudulent treatment is an outrage," said Cirkiel.
Collings said if patients misbehaved, they were put "on isolation," which meant they spent hours working, often without a break, inside or outside the facility with no pay. When they were paid, it was under the program's token economy system, a form of money that can only be used at Tangram to pay for personal toiletries, outings or recreation.
As part of "vocational therapy," patients raised animals including chickens, pigs and cows until they were ready to go to the slaughterhouse. Patients were expected to work until they were exhausted. "The work was really tough," said Collings. "We were constantly on the go from the moment we got up until the moment we went to bed." He also witnessed degrading treatment of patients by staff.
One adult brain-injured patient from Pennsylvania would often wander away from the facility. In order to "know where he was" at all times, the staff attached cow bells to his shoelaces. "I thought that was going pretty far, it was pretty humiliating," said Collings.
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