Fred Mogul, Reporter, WNYC News
Fred Mogul has been covering healthcare and medicine for WNYC since 2002.
Months after Videotape of Neglected Patient Dying Spurs Reforms, Feds Fault City Psych Ward in Brooklyn for Continuing Problems
Novelist Charles Dickens visited a New York City mental hospital in the 1840s and reported on dismal conditions there. Forty years later, journalist Nellie Bly had herself committed for 10 days to the same facility on what’s now known as Roosevelt Island and wrote a landmark expose about it. Together, they helped etch in modern consciousness the images of the abject lunatic asylum as Hell on earth – a place where physical violence, sexual invasion and gross neglect amount to the triumph of anarchy and chaos.
A new federal report paints a similarly dire picture of the psychiatric ward at Kings County Hospital Center, in Brooklyn, where patients allegedly beat and sometimes rape one another, and staff allegedly ignore patients and use sporadic, ineffective methods of treating violent or suicidal people with severe psychopathologies.
All this comes six months after a videotape was released showing a woman in the psychiatric emergency room waiting area for 24 hours, collapsing on the floor face-down, being ignored by staff for an hour, and then dying. The death of 49-year-old immigrant Esmin Green led to new hospital leadership and pledges of reform. But U.S. Justice Department investigators, working off Kings County Hospital's own incident reports as well as their own interviews and observations, say many of the solutions aren't working and profound problems persist. Many of the incidents that they, civil rights attorneys, and the hospital itself are reporting occurred late in 2008 and within the past few weeks.
Take a look: US Justice Dept Report on Kings County Hospital
DoJ investigators also allege that everything from infection control to food handling to record-keeping -- basic, crucial elements in operating any hospital -- are flawed. They allege Kings County Hospital 'fails to meet the fundamental requirements for the treatment and rehabilitation of its patients.'
Almost every page of the 58-page report released Thursday uses words like 'ineffective,' 'inadequate' and 'improper' to describe how staff observe, restrain, medicate and treat patients. Numerous paragraphs read like this one: '[Kings County Hospital Center] informs us that it has recently instituted a new 'Violence Reduction Program.' The VRP fails to promote understanding of the [causes] of the violent behavior or to guide the treatment of aggressive patients accordingly. Instead, it focuses on patient self-management skills . . . Violence prevention is not integrated into routine assessment, reassessment and treatment planning.'
The HHC has cooperated with investigators and, while disputing some facts, basically acknowledged that much of the description is accurate and many improvements have been slow to take root. They have replaced the hospital's leadership, increased staffing and available space to reduce overcrowding and long waits, and instituted new protocols for treating and securing patients. They say that violent assaults have decreased - though they did not furnish figures - and that it will take time to eliminate all the incidents like those detailed in the Justice Department report.
Here's what HHC President Alan Aviles said Thursday (PDF).
Advocates say it will take a federal legal settlement and extended, intensified and independent monitoring to improve conditions at Kings County. Millions of dollars in lawsuit payouts are likely.
Kings County Hospital Center: http://www.ci.nyc.ny.us/html/hhc/html/facilities/kings.shtml