Psychiatric hospital in 'crisis'

Weston facility overcrowded, records show; staff overworked, union says

August 19, 2010

CHARLESTON, W.Va. -- In July 2008, a state report revealed troubling conditions at Huntington's Mildred Mitchell-Bateman Hospital. Many of the state-run psychiatric facility's patients slept on cots. Some had no bathrooms. Employees worked back-to-back shifts.

Now, two years later and 150 miles northeast, a similar situation has unfolded at the state's other psychiatric hospital, William R. Sharpe Jr. Hospital in Weston.

Records show that the facility is consistently overcrowded. Union representatives say working conditions put employees and patients in danger.

The problems at Sharpe follow a publicized series of hearings in Kanawha County Circuit Court last year. The hearings in Judge Duke Bloom's courtroom were part of an ongoing, decades-old lawsuit about the way West Virginia administers mental health care.

Although both hospitals have struggled with overcrowding in the past, the 2009 hearings focused mostly on Bateman. Bloom later issued court orders to make the state improve mental health services.

Last July, Bloom made David Sudbeck a court monitor tracking the state's progress.

"The judge and I are very concerned about the overbedding at Sharpe," Sudbeck told the Gazette-Mail last week. "When you have overbedding at any hospital, probably patients are going to be more aggravated . . . You're also going to have staff that may be pulling a double shift."

Sudbeck had previously served as the state's ombudsman for mental health. He wrote the 2008 report on Bateman's overcrowding. As a court monitor, he now works for Bloom, giving him independence from the state and more authority.

Over the past two weeks, Sudbeck said, eight to 10 Sharpe employees have told him about problems. He plans an investigation later this month, focusing on the hospital's physical condition, patient treatment, staffing levels and other issues.

The state Department of Health and Human Resources is making progress on developing group homes meant to ease overcrowding at the hospitals, Sudbeck said.

"They've not always met the original timelines, but yes, progress is definitely being made," he said. "It's an involved process. It takes a lot of time, and it's a lot of work."

Still, in an e-mail to a Sharpe employee, Sudbeck described the situation at Sharpe as a "crisis."

Sharpe is licensed for 150 beds. Bateman has 110.

Figures provided by the state show that, in recent months, Bateman has stayed under its licensed limit, while Sharpe has had more patients than licensed beds every day.

On one day during the first week of August, 171 patients stayed at Sharpe. Both facilities also are sending dozens of patients to private hospitals every day.

Mental-health advocates say hospital overcrowding is not simply a symptom of bed shortages. It's also a sign that services are lacking in communities, they say. Those options -- such as group homes, employment programs, and crisis-intervention centers -- can help people function and not be institutionalized.

When communities lack such services, hospitals end up with logjams, said Ron Honberg, director for policy and legal affairs at the National Alliance on Mental Illness.

People who could live on their own with proper support instead must be hospitalized, he said. Often, patients who still need help but are stable enough to be discharged must stay in the hospital because their doctors know they won't be able to get community-based services after they leave.

"The longer you are in an institutional setting," Honberg said, "the harder it is to reintegrate back into the community."

States across the country struggle with hospital overcrowding, he said. The economic downturn has played a large role. In its 2009 report, "Grading the States," NAMI gave West Virginia an 'F' for its mental health care system.

Hospital employees face high stress and very difficult patients, Honberg said. "These are tough jobs, and oftentimes not very high-paid jobs."

In June, Sharpe employees wrote to several state lawmakers.

"Patients are allowed to assault, curse, spit on, threaten staff and destroy state property without any action being taken," the employees wrote.

Among other allegations, the employees say staffers have been fired without reason, and that most patients are now "forensic." That means they have been court-ordered into the hospital, determined to be unfit to stand trial, or found not guilty by reason of insanity.

"Staff are now working with more violent patients from jail and prisons without being compensated nor having the means to control these patients," they wrote.

Union representatives allege that managers have retaliated against workers who complain.

"Frustration has just been building and building," said Gordon Simmons, field organizer for the West Virginia Public Workers Union UE Local 170. "They feel absolutely jerked around by the administration."

A DHHR spokeswoman said the official who oversees West Virginia's behavioral health services and facilities was unavailable for an interview last week. The state responded in writing to the Gazette-Mail's questions.

"Retaliation against employees is not tolerated at any of our facilities and all state employees have access to the State Grievance process for any and all issues related to their employment," officials said. "Further, DHHR allows access to our facilities by union organizers. All employees have the option to have union representation if they so choose."

Forensic admissions have steadily increased at both hospitals, meaning there are fewer beds for other patients, according to the statement.

Officials say they have taken steps to alleviate overcrowding at Bateman and Sharpe, as required by Bloom's court orders. Among other things, six group homes are in the works.

"More group homes, residential housing and day treatment will be allocated in this fiscal year," the department said, "to assist in the placing of individuals in the least restrictive appropriate setting."

Reach Alison Knezevich a alis...@wvgazette.com or 304-348-1240.