Feds chastise State Hospital for wanton use of restraint
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By Lisa Rathke Associated Press - Published: July 8, 2005
MONTPELIER — The Vermont State Hospital failed to protect patients from harm and used restraints and seclusion excessively, the U.S. Department of Justice has found.
Following an investigation from Aug. 30 through Sept. 2, 2004, the civil rights division of the Department of Justice concluded that hospital provided inadequate psychiatric and psychological services and jail-like settings that were not conducive to recovery.
The criticisms were not news to state officials and employees of the troubled psychiatric hospital.
"We knew this report would be harsh," Health Commissioner Paul Jarris said Thursday. "Our objective here is to fix the situation."
Jarris said the report, released Thursday, was similar to the findings of the Centers for Medicare and Medicaid Services, which has investigated the hospital several times since two patient committed suicide in 2003 and pulled the hospital's certification and millions of dollars in federal funding.
"The findings contained in this report go to the heart of the systemic deficiencies we identified last year and have been working on ever since," said Jarris.
The report was most critical of the hospital's use of restraint, which substantially exceeds the national average for psychiatric hospitals, the report said.
"VSH consistently uses seclusion and restraint as an intervention of first resort and fails to consider lesser restrictive alternatives," the report said.
In 90 percent of restraint incidents, the patient was strapped to a bed in a seclusion room, the report said.
"To use five point restraints consistently as the most widely relied upon restraint method at VSH without any guidelines or policies governing its use substantially departs from accepted professional practices, is dangerous, and exposes VSH patients to a significant risk of death or injury," the report found.
The report also concluded the hospital lacked a system for collecting and tracking incidents of harm and abuse and failed to provide adequate treatment planning psychiatric assessments and diagnoses, medication management and discharge planning and placement.
The report noted the cooperation of staff and state officials with the investigation. Jarris said the state would meet with the DOJ to go over the recommendations.
Over the past year the state has worked to turn what historically has been a custodial facility to a hospital, Jarris said.
The state has a contract with Fletcher Allen Health Care to oversee psychiatric and clinical services at the hospital, he said.
The contract calls for increasing the ratio of nurses and health care workers, and recruiting new academic physicians, Jarris said.
The state also is renovating parts of the hospital to make them more safe and conducive to recovery. Staff also has been trained to use restraint and seclusion of patients as a last resort, he said.
State officials continue to work on plans to close the hospital and possibly replace it with another facility for the most mentally ill patients.
The Legislature allocated money to start planning for a new hospital.
"We need a new facility. We intend to do that as soon as possible," Jarris said.
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