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Citizens Commission on Human Rights: State Hospitals are Still Snakepits of Patient Abuse, Betrayal of the Public
Numerous state psychiatric hospitals have recently been exposed for violations and/or deficiencies in patient care and safety, including several that have come under U.S. Department of Justice (DOJ) investigation. The reports show that these facilities are not safe, sanitary or rehabilitative places. The DOJ reports in particular found near-identical violations and deficiencies in each facility it investigated—including inappropriate, excessive or inadequately documented use of seclusion and restraints, as well as drugs being used as chemical restraints.The number of hospitals and the range of similar abuses throw up a red flag that says “systemic patient civil rights abuses.” Often referred to as “snakepits” in the early 1900's, for prevalence of violence and degradation and absence of rehabilitation, today's state mental institutions don't appear to have changed much.The reports:
Investigators from the Connecticut state Department of Public Health visited the Connecticut Valley Hospital (CVH, Connecticut's oldest and largest public psychiatric hospital) on September 12, 2007 to look into a patient suicide by hanging—the fourth suicide at the hospital in as many years. While the suicide is tragic enough, the investigators found additional problems at the facility and cited it on behalf of the Centers For Medicare and Medicaid Services, which provides millions of dollars of funding annually to CVH. Among the problems found was that patients are often restrained as “first resort” and as a staff convenience.
In August 2007, a Delaware state investigative committee held a four-hour hearing into abuses at the Delaware Psychiatric Center (DPC). Mothers, fathers, sisters and brothers addressed the committee in excruciating detail about the physical and sexual abuse of their loved ones—patients of the DPC. A former DPC attendant was arrested following a police investigation into a patient whose jaw was broken in three places, on both sides of his mouth. DPC officials at first claimed the patient tripped and hit his chin on a bed frame. In August, state troopers also arrested another former attendant accused of raping a patient.
A May 2007 study of conditions at the Georgia Regional Hospital in Atlanta, commissioned by the Georgia Department of Human Resources, uncovered numerous violations, including physical restraints of patients for no documented reason. The Department of Human Resources' report follows an investigation by
The Atlanta Journal-Constitution
that reported at least 115 patients at Georgia's state hospital had died under suspiciouscircumstances between 2002 and 2006. The newspaper also found 194 confirmed cases of physical or sexual abuse. In the state hospital in Savannah, surveyors found, among other things, failure to document the reasons for the use of restraint or seclusion and the use of movies screenings and bingo counted as patient therapy sessions (indicative of fraud).
A May 2006 report by the U.S. DOJ on California's Patton State Hospital found that its psychiatry and psychology services “substantially depart from generally accepted professional standards of care and exposepatients to…risk of harm and actual harm.” The report runs down a litany of the facility's failures, including failure to properly diagnose; routine prescribing of inappropriate or unsafe medications without clinical justification; use of restraints and seclusion as a first course of action and the “strikingly high” use of PRN (
pro re nata,
“as needed”) medication as a form of chemical restraint. Further, it found the hospital failed to foster asafe environment for patients, citing 500 patient-on-patient acts of violence in the preceding six months and a recent trend of suicide and attempted suicide by hanging.
Another May 2006 DOJ report on St. Elizabeth's Hospital in Washington, DC found that the facility “fails to provide its patients with a reasonably safe living environment…patients are subjected to assaults and harm from elopements and suicides…are subjected to undue seclusion and restraints.” One particularly egregious finding was that the hospital's forensic unit restrained or secluded patients for 1,387 hours on weekends compared to 63.62 hours during the week, which “indicates and over-reliance on…seclusion and restraints to compensate for shortage of staff…on weekends.” The DOJ's 66-page report details deficiencies and violations and failures to meet the standard of care across all areas investigated.
The DOJ's July 5, 2005 report on Vermont State Hospital not surprisingly found, among other things, that the institution “consistently uses seclusion and restraint as an intervention of first resort”; “often uses seclusion andrestraint for the convenience of staff and/or as initial punishment” and that “Over 90% of restraint incidents at Vermont State Hospital involve strapping patients down to a bed in five-point restraints in a seclusion room - the most restrictive and dangerous form of intervention.” Similar to the aforementioned facilities, the DOJ found deficiencies, violations and departures from standard practice in all areas investigated.
In March 2004, the U.S. DOJ released the findings of their investigation of all four North Carolina state hospitals, which include inappropriate use of restraints and seclusion and failure to ensure reasonable safety