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Illinois Report Blasts Care at Psychiatric Hospitals

Illinois’ child welfare agency released an 84-page report Friday detailing violence and abuse at one of Illinois’ largest psychiatric hospitals, as well as troubles throughout the 95-hospital chain owned by Nashville-based Psychiatric Solutions.

The review comes after ProPublica and the Chicago Tribune reported in February about juvenile sexual assaults and an unreported death at Riveredge Hospital. Last July, a Tribune investigation disclosed unreported violence among juvenile patients and spurred the child welfare agency to stop sending youths in state care to the facility.

“This facility remains on intake hold,” said Kendall Marlowe, spokesman for the Illinois Department of Children and Family Services, of Riveredge Hospital. “The care provided by Riveredge was completely unacceptable, and we remain outraged at the pain and violence suffered by innocent children in this facility’s care.”

The state’s announcement came with the release of the critical report by researchers from the University of Illinois at Chicago. The report chronicles abuses at Riveredge and many of the hospitals owned by Psychatric Solutions Inc. of Nashville, Tenn. Officials from the company, which operates in 30 states, could not immediately be reached for comment.

ProPublica and the Los Angeles Times reported in November about lapses in patient care at the company’s hospitals.

Riveredge owner Psychiatric Solutions Inc. issued a written statement to the Tribune saying that “from a historical perspective, we are disappointed with any incidents that occurred at the facility and deeply regret and apologize for any harm to one of our patients. However, since September 2008, we have not had any significant incidents at the facility and have provided quality care to our patients in a safe, therapeutic environment. Based on the care being provided today, we disagree with the report’s focus, conclusions, and final recommendations.”

The report says DCFS “can have no reliable basis at this time” to send youth in state custody to the hospital.

The Illinois hospital review faulted Psychiatric Solutions executives for “blaming downward or blaming outward when things go wrong,” saying executives too easily rationalized problems by pointing to staff lapses or patients who fail to follow the rules.

“While this sort of organizational firewall provides a certain level of deniability for the hospital and corporate leadership, (the state) has a right to expect more with regard to systemic accountability from a major healthcare provider to whom it entrusts the treatment and safety of its wards,” said the report, written by Ronald Davidson, director of the UIC Mental Health Policy Program.

The report details “longstanding and recurring problems” throughout the hospital chain, including “unreliable incident reporting,” multiple patient deaths and the sexual assault of one 5-year-old patient. Corporate officials did not know about patient care problems “until the issues were dragged into the sunlight by the state investigators or – in some instances – the news media,” the report said.

“As the leadership of the largest psychiatric hospital corporation in the United States, however, they should have known,” the report says.

The researchers delved far into Riveredge Hospital records, examining the case of a 12-year-old boy who alleged in 2006 that he was raped three times by a 15-year-old boy. Riveredge’s internal documents described the boy as “easily agitated” with a “tendency to fight with others.”  The hospital’s report to a regulatory body had concluded that the 12-year-old’s claim of being a rape victim “appears inconsistent with the passive behaviors he describes for these incidents.”

The researchers challenged that characterization. “Such an offensive innuendo, if made by a defense attorney cross-examining a rape victim, would likely be slapped down hard and fast by the judge as grossly improper,” the report says. “…Implying that the victim might not be entirely truthful, it nevertheless raises some very troubling questions about the integrity of system-related accountability within this organization.”

Child welfare officials also said Friday that they will seek to increase the number of psychiatric hospital monitors within the department and will work with other state and federal agencies to explore policy changes.

Read the Illinois Department of Children and Family Services report.

Updated April 4, 10:25 a.m.: This story has been updated to include a response by Psychiatric Solutions Inc. to the Chicago Tribune.

Hospital chains?!  When did this start happening?

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