After a critical report called for more oversight of Connecticut's state-run psychiatric facilities, lawmakers will consider whether new safeguards are needed.
An investigation released in May by Disability Rights Connecticut (DRCT) raised concern about practices at an inpatient psychiatric facility in New Haven. Findings pertained to patient safety, patient-on-patient sexual abuse and harassment, and use of restraint and seclusion.
The nonprofit launched its investigation after receiving multiple complaints concerning the Connecticut Mental Health Center, which is run by the state Department of Mental Health and Addiction Services (DMHAS).
“Outside entities are not really looking at what's going on at Connecticut Mental Health Center or other inpatient psychiatric hospitals that are owned by the state, with the exception of one,” said Rachel Mirsky, supervising attorney at DRCT.
That exception is Whiting Forensic Hospital in Middletown, which is now subject to additional oversight from the Department of Public Health (DPH) following a patient abuse scandal in 2017 that led to criminal charges against staff. Connecticut also previously entered into a settlement with the U.S. Department of Justice over the operation of the facility.
“In reviewing that report and the settlement, we noticed many of the same themes that we identified at Connecticut Mental Health Center,” Mirsky said, referring to the state’s previous agreement with federal officials about conditions at Whiting.
“It's very alarming to us that we're seeing some of the same things in another facility that the federal government has not gone to,” she said.
Mirsky said other psychiatric facilities run by DMHAS urgently need more independent oversight. Among them are Capitol Region Mental Health Center in Hartford and the Greater Bridgeport Community Mental Health Center.
Lawmakers on the Public Health Committee could take up the issue in the coming legislative session next year. State Sen. Saud Anwar, who chairs the committee, said the group will weigh options such as expanding oversight by DPH.
“I am concerned that in a state-owned facility, we are allowing this to happen,” Anwar said. “Now keep in mind that if this was a non-public entity, they would be in far bigger trouble. If it was a hospital psychiatric unit, and there were these kind of complaints, and this kind of data, [the] Department of Public Health would be there breathing down their necks.”
Surveyors from DPH do have the ability to inspect state-run psychiatric facilities as a condition of their participation in the federal Medicare and Medicaid programs. Celeste Cremin-Endes, chief of state-operated services for DMHAS, said health officials in Connecticut can inspect them at any time, and have exercised that power before.
Cremin-Endes said DMHAS welcomes more assistance, but expressed confidence that psychiatric facilities run by the state already receive rigorous oversight, including through a triennial accreditation process.
"The standards are extensive, and really follow care from point of entry to point of discharge and beyond,” she said.
Cremin-Endes said the department also welcomes feedback from DRCT, but disagrees with some of the group's findings about practices at the Connecticut Mental Health Center. She noted that the center was selected this year as a training site for other institutions by its accrediting body, the Joint Commission.
"I totally, completely believe that we are an entity that provides the highest level of care for a population that deserves the very best level of care,” she said.
Budget limitations could influence DPH’s future role. Anwar recalled that a proposal last year for DPH staff to oversee health care in the correctional system would have come with significant expenses.
The bill, S.B. 957, called for the state to create a new office within DPH to oversee prison medical programs at an estimated cost of around $1.2 million over two years, according to a fiscal note.
“That's why it was challenging to be able to appropriate that kind of resources,” Anwar said, “especially since we have the fiscal guardrails which just limit us to be able to do the right thing for the most vulnerable people in our state.”
“But if the financial issues and budgetary restraints restrict us, then we’ll have to find other options,” he said.
Connecticut Public’s Jim Haddadin and Michayla Savitt contributed to this story.
