By Staff
(This editorial originally appeared in The News &Observer of Raleigh.)
Mistreatment of mentally ill people in America is as old as colonial times, and as fresh as the reporting in the weekend’s editions of The News &Observer.
Accounts and evidence of abuse (and worse) in the final two segments of The N&O’s ‘‘Mental Disorder’’ series were painful to behold. They told of beatings of patients in North Carolina’s state mental hospitals, of workers hired despite long criminal records, of suspicious deaths unreported to the state, even though a 2001 law requires such reporting. In one case, a district attorney apparently was not informed after a mental-hospital patient’s death in his district had been ruled a homicide.
There were photos of a beaten patient’s face — a law officer described it as looking like ‘‘hamburger meat’’ — along with the finding that the tread on a hospital employee’s shoe matched up with bruises on that patient’s skin.
There was the heart-rending story of the death of Janella Williams of Beaufort County. She had become agitated and combative at Cherry Hospital in Goldsboro, was strapped down and injected with a powerful tranquilizer — and soon after was medicated again. When a staff member checked on her, Williams had stopped breathing. ‘‘We lost her,’’ was all a doctor would tell the family. (The case has been settled with a $275,000 payment to Williams’ survivors and a promise by hospital administrators to do better.)
A quote from former Cherry Hospital staff psychiatrist William O. Mann III summed up conditions he found at the facility: ‘‘In the 14 months I worked at Cherry Hospital, I saw more cases of patient abuse than I have in the rest of my career.’’ Most hospital staff members do good work, he noted, but a few hurt patients ‘‘to teach them a lesson.’’
These are patients, mind you, who are beset by life-threatening illnesses that are as real as cancer or heart disease. Patients for whom care in the state system is the last and probably only resort.
And yes, patients who can be more than a handful. Some turn violent, threatening themselves or staff members with injury — and occasionally making good on those threats. Almost by definition, many patients act irrationally.
Working with such patients is not an easy job for anyone. In North Carolina the task of interacting with them falls most frequently to lower-level employees in state hospitals — people whose salaries are notably low. Some of the former employees listed in an N&O summary of abuse or neglect cases earned less than $20,000 a year. It’s unrealistic to think the state can consistently get or keep well-qualified and well-trained help for that kind of money. Fortunately, a review of lower-level salaries is under way.
Besides making it possible to hire better help, what can be done?
With the mental health system in disarray and tens if not hundreds of millions of dollars spent inappropriately on ‘‘community support’’ services, maintaining — not closing — regional psychiatric hospitals is essential. In a system that has ‘‘privatized’’ much local care to near-extinction, there’s little effective community-based treatment. The hospitals have to be an option.
Federal authorities, who control much of the funding, have begin to crack down on abuses here. Dempsey Benton, head of the state Department of Health and Human Services since his appointment in May by Governor Easley with instructions to straighten out the mental health mess, says he’d support a law to require that all hospital deaths be reported to the state. That would eliminate sparring over which deaths are truly ‘‘suspicious,’’ and shine more light.
Increased video monitoring might cause potentially abusive staff members to have second thoughts. For jobs dealing with vulnerable people, a prohibition on hiring staff with criminal records would be wise.
Mental health abuses go back centuries; so do efforts to fix things. Abuses detailed in the ‘‘Mental Disorder’’ series prove North Carolina has far to go before it can lay claim to real reform.