State votes to investigate abuse at psychiatric center

By: David DiNicola and Caroline Ferguson on October 8th, 2014.
With less than a month until Election Day, Maine politicians are stepping over party lines to ensure accountability for the treatment of some of the state’s most vulnerable residents. On Wednesday, Sept. 24, the Maine State Government Oversight Committee voted unanimously to investigate Riverview Psychiatric Center in response to reports of widespread patient abuse.

Maine’s Office of Program Evaluation & Government Accountability (OPEGA) received a number of testimonials from employees at Riverview that requested the State to examine the hospital’s procedures for reporting the mistreatment of patients. These requests came in conjunction with two separate investigations conducted by the Kennebec Journal and the Portland Press Herald and followed a report released by the Division of Licensing and Regulatory Services to the Maine Sunday Telegram. These reports described video footage of 30-year-old Riverview resident Arlene Edson following a Dec. 2 verbal dispute with correctional officers, as she cowered naked in her room before the officers proceeded to pepper spray and forcibly restrain her.

“I felt like I was burning all down my back. I screamed for a shower for hours but they wouldn’t let me take a shower,” Edson said in an interview with the Portland Press Herald. A few months prior to the incident, in Sept. of 2013, the hospital lost its certification from the federal Centers for Medicaid and Medicare Services, along with $20 million in federal funding.

“It all kind of came to a head in the past few months,” said Republican Senator Roger J. Katz (P’06). Katz represents Maine’s 24th District, which includes a number of communities in Kennebec County—China, Oakland, Sidney, Vassalboro and Augusta, where Riverview is located. Katz became aware of the incident in December 2013 when an employee informed him about the event. Since then, at least ten current and former employees have come forward to complain about conditions at the hospital.

A longtime social worker at Riverview, Judith Dorsey, was fired for stepping forward and speaking out about the issues at the Center. According to Dorsey, Riverview’s dysfunction is both long-standing and pervasive: “There is a culture of abuse towards patients and staff alike, and I think that it’s a deep-rooted problem going back [into the hospital’s history].”

Katz believes that the problems at Riverview fall into a number of categories—the first being instances of excessive force, as alleged in Edson’s case. Abuse, however, extends beyond the pepper spray. “There’s also a suggestion that patients are being put into seclusion many times the rates of the national average,” Katz said.

“The culture of the hospital is such that it leads to an environment where there [are] more patients acting out and assaults than there ought to be,” Katz said. “And when incidents happen, they’re not being reported appropriately up the chain of command.”

“I was very proud to work there at first,” Dorsey said. “But then it devolved into something I was not proud [of]….When I confronted it, I was the one that lost my job, not the abusers.”

While election season is in full swing, Katz is proud of the bipartisan work Maine politicians have accomplished in coming to this decision. “[The Government Oversight Committee] is unlike any other committee where the majority has more seats at the table than the minority does,” Katz said. “There’s obviously some people on both sides of the aisle who might like to score political points with this, but I think those of us on the Committee have stayed true to our mission of non-partisan work, and I think that that’s evidenced in the fact that the vote to go ahead here was 12 to nothing.”

Katz’s interest in Riverview is prompted in part by the fact that the hospital falls within his district. However, his personal investment extends back to his college years in which he worked on a pilot project at what was then the Augusta State Hospital as a patient advocate. “It was a very different world. This was at the old facility across the river and there was something like 1,500 patients there at the time, as opposed to the 92 beds at Riverview,” Katz said.

While on the job, Katz’s role was to start thinking about a model in which there was someone whose specific role it was to advocate for patient rights within the hospital. “We set up a patient advisory council and began work on a mechanism where there was a way for patients to make complaints about treatment or other issues within the facility,” Katz said. “There was a whole different way in which society dealt with the mentally ill before the collective decision was made to try to deinstitutionalize as many as possible.”

In recent years, the deinstitutionalization of mental health patients in Augusta has been a hot-button issue for residents and politicians alike. Riverview is the only facility in the state that accepts forensic patients, or those who have committed violent acts but are found not criminally responsible due to mental illness, and some patients are moved to nearby group homes after being released. In October of 2012, over 150 Augusta residents signed a petition in response to the burden of group homes housing released forensic patients from across the state who committed violent acts.

Then-mayor William Stokes expressed his distress in an interview with the Kennebec Journal: “The issue for me is why is Augusta bearing the entire burden of this?… Other communities should be sharing the burden. It can’t all be dumped on us…”

Katz noted that he voiced similar concerns during his time as mayor of the city. “A lot of the services for mental health consumers are located here in our community, so we house a disproportionate number of folks who are being released from the hospital,” Katz said. However, he also expressed confidence in the local community, so long as appropriate treatment could be ensured for Riverview patients: “We have the unique position of having many of these folks within our community after they are discharged. We are kind of the poster child for dealing with special populations.”

Despite allegations and push back from the local community, Riverview has continued to receive vital accreditations from the Joint Commission, a nonprofit organization that accredits over 20,000 healthcare organizations throughout the country.

Interim Superintendent Jay Harper is optimistic about the hospital’s ability to work toward continued improvement. In an interview with the Portland Press Herald, Harper reported the hiring of three additional psychologists, upgraded therapy offerings, an increase in the training budget from $4,000 to $60,000 and improvements to hospital culture for employees and patients alike. “There are a lot of incentives built into the system now for employees to find alternative ways to deal with situations other than seclusion,” Harper said.

This notion of recovery has recently been reflected in many aspects of Riverview’s operations. In the face of continued pressure from both the media and the Maine State government, the sign standing outside of the hospital’s facilities was changed from “Riverview Psychiatric Center” to the “Riverview Psychiatric Recovery Center.”

Katz, however, remains vigilant. “To me, the name change is irrelevant,” he said. “What goes on inside is the important thing.”

“You can throw a lot of money at a problem, but you have to change the culture, too,” Dorsey said. “These people deserve good care, just like the rest of us.”

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