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Two years after the end of federal oversight at St. Elizabeths Hospital, the city-run institution for the mentally ill remains a staggeringly dangerous place.
The numbers are alarming: In one year alone, there were 632 assaults, 384 injuries, and 524 incidents of physical and mechanical restraint, according to a recent report by a nonprofit watchdog organization. According to the latest city figures, the average daily census is less than 300 patients.
“Given the serious problem with safety at St. Elizabeths, the Department of Behavioral Health should perform its own investigation of the problem,” Disability Rights DC concluded in a report circulated to city officials on Sept. 26.
The organization also recently concluded two other substantiated investigations into abuse accusations. In all three investigations, the findings revealed hospital staff failing to follow the city’s own laws regarding the use of restraints.
“Obviously, it’s concerning,” says Mary Nell Clark, an attorney with Disability Rights DC. Clark says city officials have agreed to meet and discuss the findings, which come nearly two years after the hospital emerged from Justice Department oversight. Disability Rights is part of the D.C.-based University Legal Services, a nonprofit that has sued for reforms on behalf of patients.
“We very much appreciate the city’s response that they’re willing to work with us to try to improve and acknowledging there are definitely some issues here,” Clark says. In addition, Clark notes the findings highlight a need for greater staff support and training.
Among other conclusions, the investigations found:
• Video evidence of a staff member dragging a patient across the floor.
• A patient had been physically restrained 60 times in a year, but the staff failed to follow rules requiring the hospital to try less restrictive methods first.
• Hospital staff never seriously explored one patient’s repeated complaints about sexual abuse by peers and staff.
• A staff member threw his arm around a patient’s neck and straddled the patient on the visitor’s room floor. While St. Elizabeths’ own investigation found staff abuse, the hospital “failed to recommend significant or sufficient corrective action.”
Phyllis Jones, legislative affairs and public affairs director for the Department of Behavioral Health, declined to make Department of Behavioral Health Director Dr. Tanya Royster and new hospital chief executive Mark Chastang available for interviews—the same week both officials appeared on WAMU to discuss the hospital with Kojo Namdi.
Instead, Jones emailed a statement: “The Department of Behavioral Health and ULS [University Legal Services] share the same goals of high quality patient care and a safe hospital environment. Saint Elizabeths has safety protocols, violence-prevention plans, and mandatory staff training on de-escalation techniques. Even with these actions, we look for ways to make the hospital even safer for patients and staff and will meet with ULS to discuss their recommendations.”
During the radio appearance, Chastang also weighed in on a recent City Paper story on the life and death of St. Elizabeths’ patient Franklin Frye, who spent more than 40 years in the hospital until his death earlier this year. The court system lost track of Franklin’s case for years.
Found not guilty by reason of insanity for stealing a $20 necklace, both Frye and his family complained about abusive treatment they said he received in the hospital over the years.
After Franklin’s death, city officials invoked the sweeping federal law governing patient confidentiality—the Health Insurance Portability and Accountability Act—as the reason they could not discuss Franklin’s care in detail with City Paper last month.
Nonetheless, Chastang declared on WAMU, without challenge, that Franklin received “excellent care.”
Following the interview, Jones declined a request for Chastang to discuss Franklin’s care with City Paper and members of the Frye family, saying the hospital already met with the family.