Probe on mental health management sought

Reports from the island of Guam, via the Marianas Variety newspaper, regarding what appears to be small time politics and corruption at hospital in the western Pacific. Hopefully this doesn't turn out like another case of Nurse Ratchet from One Flew Over The Cuckoo's Nest

Reports of violations, mismanagement and clients’ security risks at the Department of Mental Health and Substance Abuse, or DMHSA, have reached the District Court of Guam, which received another letter asking to investigate the agency.

Magistrate Judge Joaquin Manibusan Jr., who is the designated special master for the permanent injunction against DMHSA and the Department of Integrated Services for Individuals with Disabilities, or DISID, said this is the second time that the court received an anonymous letter reporting several irregularities in the department.

The first anonymous letter was faxed by DMHSA employees in June, urging a federal takeover of DMHSA and DISID to improve the services to persons with disabilities.

The second letter was sent by a client to the chamber of Judge Manibusan, asking about who runs the mental health department.

According to the anonymous client, despite the designation of Dr. Andrea Leitheiser as acting director of DMHSA, the department is being run by Dr. Judith Avery, the nurse administrator who reportedly approves all the actions taken by the agency.

The letter sender reported that Avery, who was allegedly fired from the Division of Mental Health in the CNMI for illegal practice, is also violating government of Guam rules and regulations for working with Guam Community College at the same time.

As far as the permanent injunction is concerned, the client alleged that Avery wants to keep the situation in the department under her control to protect her standing and her annual salary of $90,000.

The client also noted the lack of security at DMHSA and the new unit that provides housing to clients from the Department of Corrections, adding that “this has become more dangerous for the staffers who work in this building.”

The client also reported that for the past six months, no psychiatrist wants to service DMHSA because they refused to work with Leitheiser, who is earning $120,000 a year, and Dr. Laura Post, whose annual salary is $150,000.

“In the past, there were two psychiatrists (Dr. Renato Gahol and Dr. Ruby Manalastas) who were hired to provide service to DMHSA clients. They felt they were unable to work with these doctors,” the client said.

Recently, a family client filed a complaint against DMHSA for its failure to provide service to a client.

The letter sender told the court that Gahol informed Lt. Gov. Mike Cruz about the situation, but did not act on it because of the permanent injunction pending against DMHSA and DISID.

Last month, the court was forced to send off-island a defendant who terrorized the Andersen Air Force Base after no psychologists or psychiatrists could conduct an examination to determine if he is mentally fit to stand trial or face the charges.

Ricardo Unpingco Palomo Jr. was arrested for terrorizing the AAFB with a handmade explosive device on Sept. 22. After DMHSA did not conduct a forensic evaluation on him, the court ordered the U.S. Marshals to transport the defendant to an appropriate Bureau of Prisons facility so that an appropriate psychiatric or psychological examination can be conducted on him.

The court received a letter from Post stating that DMSHA has concerns about assisting the court on Palomo’s case.

The client added that problems stated in the permanent injunction still exist with no clear answers to address them.

“An investigation into this matter is needed for the welfare of the island clients that need the service,” the client said.

[...]

Two court monitors

Meanwhile, visiting Judge Consuelo Marshall has approved the appointment of two court monitors in connection with the local government’s compliance with court orders related to the permanent injunction imposed on GovGuam, DISID and DMHSA.

Judge Marshall ordered the appointment of James Casey and Dr. James Kiffer to serve jointly as court monitors for a monthly salary of $8,000 each.

The judge said she is persuaded that approving each party’s nominee will enable the parties to finally resolve the case to the benefit of the community, adding that appointing Guam-based monitors is more efficient and less costly than appointing off-island monitors.

The court monitors, who can be removed or replaced by the court if it deems necessary, were ordered to submit a monthly report on or before the first day of each month. The first deadline for their first report is on Jan. 2, 2008.

Because the plaintiffs find the defendants’ proposed list of measurable milestones “too vague and conclusory” to benefit both court monitors, Judge Marshall ordered the parties to meet and confer regarding appropriate measures or additions to the list of measurable milestones.

The court gave both parties until Dec. 14, 2007 to submit the amended list of milestones.

Judge Marshall also ordered the parties to appear for a status conference on March 14, 2008 at 10 a.m. to assess the effectiveness of the court monitor appointments and the defendants’ progress in implementing the amended permanent injunction.