Md. agrees to new poli­cies at its men­tal hospi­tals

Changes part of set­tle­ment in suit over sex­ual as­saults

Baltimore Sun - - FRONT PAGE - By Andrea K. McDaniels

The state will adopt new poli­cies it hopes will bet­ter pro­tect pa­tients at its men­tal hospi­tals against sex­ual as­saults as part of a pro­posed set­tle­ment with a for­mer pa­tient who was abused on two sep­a­rate oc­ca­sions, in­clud­ing by an­other pa­tient with HIV.

Af­ter 20 months of ne­go­ti­a­tions with the vic­tim’s attorneys, the De­part­ment of Health and Men­tal Hy­giene, which over­sees the state’s men­tal health fa­cil­i­ties, agreed to de­velop a safety and pro­tec­tion plan, as well as con­duct psy­chi­atric eval­u­a­tions for all pa­tients.

The agree­ment re­quires that an out­side en­tity would in­ves­ti­gate all sex­ual abuse al­le­ga­tions rather than the agency’s in­ter­nal po­lice. The de­part­ment would also en­act a stan­dard­ized pro­to­col to col­lect pa­tient med­i­cal his­to­ries to iden­tify those vul­ner­a­ble to sex­ual as­sault.

The agree­ment with Dis­abil­ity Rights Mary­land and the Ven­able law firm, both of which rep­re­sented the pa­tient, will be pre­sented to a fed­eral judge next week for fi­nal ap­proval.

The pa­tient, who was not iden­ti­fied in court records be­cause she was the vic­tim of sex­ual as­sault, was first abused in Novem­ber 2011 at Clifton T. Perkins Hos­pi­tal Cen­ter in Jes­sup, the state’s

max­i­mum-se­cu­rity men­tal hos­pi­tal, where she was sent af­ter com­mit­ting what her attorneys char­ac­ter­ized as mi­nor of­fenses. There she was as­saulted by a male pa­tient in a bath­room af­ter both were able to leave a gym­na­sium where the staff was sup­posed to mon­i­tor them.

Dur­ing the in­ves­ti­ga­tion, she was re­peat­edly ques­tioned and ac­cused of con­sent­ing to the sex. A psy­chi­a­trist later told state po­lice that she did not have the cog­ni­tive abil­ity to con­sent to sex.

She was re­leased from Perkins in Jan­uary 2012 but re­turned to state cus­tody in Oc­to­ber when she was sent to the State Se­cure Eval­u­a­tion and Ther­a­peu­tic Treat­ment fa­cil­ity in Jes­sup. There she was as­saulted in a bath­room by an­other pa­tient who was HIV-pos­i­tive and had a re­peated his­tory of sex­ual as­sault. An­other pa­tient stood at the door as a look­out.

The man who as­saulted the vic­tim was sup­posed to be in a staff mem­ber’s sight at all times be­cause of his sta­tus. The vic­tim was the only woman housed at the fa­cil­ity at the time. In­ves­ti­ga­tors once again ac­cused the vic­tim of con­sent­ing to the sex.

The vic­tim be­came sui­ci­dal and emo- tion­ally dis­traught af­ter the in­ci­dents, and attorneys said she was not given proper fol­low-up care.

Af­ter the first as­sault, she tried to wrap a sheet around her neck. She also com­plained of pain and bleed­ing. Af­ter the sec­ond one, she said she was afraid to go to bed and had dif­fi­culty sleep­ing. She ini­tially would not take med­i­ca­tion to pre­vent con­tract­ing HIV be­cause she said she wanted to die. One day she banged her head con­tin­u­ously against the bed, say­ing she wanted to die.

Attorneys for the vic­tim said the hospi­tals failed to put pro­tec­tions in place de­spite know­ing she had a his­tory of sex­ual abuse, men­tal health prob­lems and cog­ni­tive dis­abil­i­ties. An as­sess­ment by Kennedy Krieger In­sti­tute that looked at her in­tel­lec­tual and func­tional ca­pac­ity found she had dif­fi­culty learn­ing sim­ple tasks, showed lim­ited aca­demic skills and did not un­der­stand much of what was said to her.

Her attorneys blamed em­ploy­ees who weren’t trained prop­erly but also said some sim­ply failed to do their jobs.

Lau­ren Young, direc­tor of lit­i­ga­tion for Dis­abil­ity Rights Mary­land, said sys­temic change was needed. “To its credit, the de­part­ment ex­am­ined this case and took it very se­ri­ously, so we had an op­por­tu­nity to make com­pre­hen­sive change,” she said. “We­wanted to do the best we could to make sure this doesn’t con­tinue to hap­pen.”

State health of­fi­cials de­clined to dis­cuss de­tails about the set­tle­ment but ex­pressed regret over the in­ci­dents in a state­ment.

“The 2014 in­ci­dents at the heart of this case were tragic,” the state­ment said. “We are us­ing it as an im­pe­tus to train our staff to bet­ter pro­vide ap­pro­pri­ate su­per­vi­sion, for the se­cu­rity of the pa­tients we serve.”

In ad­di­tion to the sys­temic changes or­dered at the state men­tal fa­cil­i­ties, the vic­tim will be awarded $400,000, the max­i­mum al­lowed un­der state law, which will be set up in a trust af­ter at­tor­ney fees are de­ducted. The state Board of Public Works ap­proved that por­tion of the set­tle­ment last month. The state also will pay for the vic­tim to live out­side of the hos­pi­tal on her own, as well as for a med­i­cal worker who will pro­vide her daily care.

“She will get both the ser­vices she needs and a very sig­nif­i­cant pot of money that will go to pro­vide any ex­tra help that is needed for her in the fu­ture,” said Mitchell Y. Mirviss, a Ven­able at­tor­ney who took the case pro bono.

In ad­di­tion, an­other at­tor­ney, Sarah Rhine, has been as­signed to help the vic­tim make de­ci­sions in her best in­ter­est. Rhine ap­proved the set­tle­ment along with the vic­tim. She “is a kind young woman who was clearly vul­ner­a­ble to abuse but has shown in­cred­i­ble strength,” Rhine said in a state­ment. “The fact that she en­tered our health sys­tem in need of treat­ment and was vic­tim­ized in such a vi­o­lent man­ner was a fail­ure of mas­sive pro­por­tion.”

The sex­ual as­sault in­ci­dents were not the first time prob­lems have been re­ported at one of Mary­land’s state men­tal hospi­tals. Changes were made at the Perkins af­ter three pa­tients were killed by other pa­tients in 2010 and 2011.

One men­tal health ad­vo­cate ap­plauded the agree­ment.

“When psy­chi­atric pa­tients are in treat­ment fa­cil­i­ties that are sup­posed to take care of them, which clearly didn’t hap­pen in this case, it is im­por­tant to put in place pro­ce­dures so some­thing like this never hap­pens again,” said Kate Far­in­holt, ex­ec­u­tive direc­tor of the Na­tional Al­liance on Men­tal Ill­ness Mary­land.

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