Maine's Riverview Psychiatric Center has failed to abide by the terms of a decades-old consent decree by not adequately reducing the risk of injury to clients and staff and by arbitrarily limiting treatment options for patients

As reported in the Portland Press Herald

Further details at the link.

Riverview Psychiatric Center has failed to abide by the terms of a decades-old consent decree by not adequately reducing the risk of injury to clients and staff and by arbitrarily limiting treatment options for patients, according to a report issued by a former court-appointed receiver and consultant.

Elizabeth Jones was asked to report on observations she made during a three-day visit to Riverview, where the state treats its most severe mental illness cases, including patients sent there through the criminal court system.

Jones listed failures in treatment strategies, failure to provide proper interventions following aggressive acts by two patients and continued risk to patients and staff, a “serious misunderstanding of recovery model” that the hospital ascribes to, and lack of treatment and of outdoor time for Lower Saco unit patients, those who have been found not responsible for criminal conduct because of mental illness.

“Treatment options have been arbitrarily limited and, therefore, the provisions of the consent decree have been violated,” she wrote.

She said the use of seclusion and restraint need to follow consent decree requirements.

“At this time, it appeared that the requisite pro-active alternatives to seclusion and restraint have not been explored or provided consistently to the extent needed,” she wrote. “The lack of individualized treatment interventions and the lack of sufficient training and personnel support place both staff and class members at the risk of harm.”

Jones had a number of observations, including concerns that the state is no longer in compliance with the consent decree that requires individualized treatment plans and adequate staffing. The consent decree settled a lawsuit brought two decades ago by mental health advocates that holds the state mental health system to agreed-upon standards of care.

Daniel Wathen, the court master who oversees the consent decree, requested the visit following a series of problems at the hospital in Augusta, including serious attacks by patients on mental health workers and nurses, the use of a stun gun and pepper spray on patients, and a loss of federal funding estimated at $20 million annually because the Centers for Medicare and Medicaid Services had withdrawn the hospital’s certification.

Jones’ report was made public on Wednesday, though Wathen said he and Jones met immediately after the hospital visit with the commissioner of the state Department of Health & Human Services, and the hospital received a copy of the report on Monday.