DEL.ICIO.USA HIDDEN SHAME: DANGER AND DEATH IN GEORGIA'S MENTAL HOSPITALS
Mental unit needed cops to end teens' 'riot'Takeover at state hospital occurred days before Justice Department investigators visited.
The Atlanta Journal-Constitution
Published on: 09/19/07
Teenage patients broke furniture, smashed windows and attacked staff members while taking control of the adolescent unit at the state mental hospital in DeKalb County on Sept. 8.
DeKalb police carrying nightsticks quelled the uprising after breaking through a barricade erected by the psychiatric patients, according to people familiar with the episode, which also was described in state records and police reports.
One patient received minor injuries, authorities said. Staff members at Georgia Regional Hospital/Atlanta, vastly outnumbered, wrestled with several patients, and an officer on the facility's internal police force was almost hit in the head with a chair.
The episode occurred as hospital officials prepared for a visit by investigators for the U.S. Justice Department. The agency is investigating whether conditions at Georgia Regional and at the six other state-run psychiatric hospitals violate patients' civil rights. The investigators arrived at Georgia Regional on Monday.
The federal investigation began in response to articles in The Atlanta Journal-Constitution detailing questionable deaths and dangerous conditions in the state hospitals. The initial article in the series, "A Hidden Shame," focused on 14-year-old Sarah Elizabeth Crider, who died last year on the same adolescent unit where the recent disturbance occurred.
The newspaper reported that from 2002 through 2006, at least 115 patients at the seven hospitals had died under suspicious circumstances, including from neglect, abuse or poor medical care — situations exacerbated by chronic overcrowding and understaffing. Those conditions also apparently contributed to the incident at Georgia Regional, four hospital employees said.
"Riot may be the most accurate way to describe what happened," a Georgia Regional physician said this week. Like others who had reviewed the episode, the physician asked not to be identified by name because officials had not authorized hospital employees to speak publicly.
Gwen Skinner, director of the mental health division of the Georgia Department of Human Resources, which operates the state hospitals, disputed the physician's characterization. Skinner also said hospital workers did not lose control of the unit during the episode. However, she said state officials are conducting an investigation.
The evening of the disturbance, a Saturday, the adolescent unit housed two dozen patients, employees said: 17 boys and seven girls, segregated on parallel halls. Two technicians worked on each hall, and two nurses supervised both the boys and the girls.
Two boys, both of whom had been committed to the hospital for psychiatric evaluation to determine their competency to stand trial, got into a fight, hospital employees said. One technician tried to restrain the assailant; the other held the victim.
With the two nurses working inside a locked, glass-enclosed office, the other 15 boys were left unattended.
In a spree that lasted at least 50 minutes, six patients engaged in "aggressive destructive behavior," according to an internal report prepared by the hospital's risk management director. State officials released the report Tuesday after the Journal-Constitution filed a request under the state's Open Records Act.
"Tables and chairs were thrown across the room" in an effort to break into the nurses' office, the report said. Then, in an escape attempt, three patients "kicked and body slammed" a secure door that leads into a lobby that separates the boys' and girls' halls, the report said. In the lobby, the patients broke tables and cabinets and tried to burst through an exterior door.
Unable either to get outside or into the girls' hall, the patients used broken furniture to barricade the exterior door, trapping the two nurses and two technicians inside, employees said.
"At this point," the physician said, "the unit was under the control of the kids."
At least two hospital employees dialed 911, DeKalb police records indicate. One reported the staff could not handle "uncontrolled juveniles" and that the lone facility police officer was "unable to detain all the juveniles." The other caller said patients were trying to escape and that one had scaled a fence surrounding the hospital campus.
Over six tense minutes, the first caller gave the 911 operator a picture of escalating turmoil. At 6:26 p.m., patients were "attempting to break down door," the operator recorded. At 6:28, there were "17 male patients in the halls" and "doors busted open." At 6:29, "lobby is not contained." At 6:32, "patients running in the lobby throwing tables," and the hospital "does not have staff to contain them."
Police officers burst through the barricaded exterior door, employees said, and rounded up the patients. Wielding nightsticks but without drawing their firearms, the officers forced the patients face down on the floor.
Officials moved one patient to a state juvenile justice facility and another to a different unit at the hospital, Skinner said. The others remained on the adolescent unit.
With the Justice Department investigation intensifying, officials have been moving state hospital patients to two private facilities in Atlanta — Anchor and Peachford hospitals — to ease overcrowding. Under a temporary contract, the private hospitals will be paid $620 per patient, per day.
Matt Crouch, Peachford's chief executive, said Tuesday that the two hospitals, both operated by Pennsylvania-based Universal Health Services, together are accepting an average of about two state patients a day, both adults and adolescents. The patients have come from two hospitals: Georgia Regional/Atlanta and West Central Georgia Regional in Columbus, he said.
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