Leonora LaPeter Anton, Michael Braga and Anthony Cormier, Insane. Invisible. In danger. Tampa Bay Times and Sarasota Herald-Tribune, 29 October 2015. “Florida’s state-funded mental hospitals are supposed to be safe places to house and treat people who are a danger to themselves or others. But years of neglect and $100 million in budget cuts have turned them into treacherous warehouses where violence is out of control and patients can’t get the care they need.” This is a three-part series about Florida’s state-funded mental hospitals and a documentary by John Pendygraft about “three people whose lives were forever changed by the violence inside.”
Part 1, Deep cuts, rising violence, 29 October 2015:
Since 2009, violent attacks at the state’s six largest hospitals have doubled. Nearly 1,000 patients ordered to the hospitals for close supervision managed to injure themselves or someone else.
For years, the state Legislature, the governor’s office and the agencies that oversee Florida’s mental hospitals ignored the chaos and continued cutting. Then state regulators hid the full extent of violence and neglect from the public.
The Tampa Bay Times and Sarasota Herald-Tribune spent more than a year chronicling life in these institutions, interviewing patients and their families and examining thousands of pages of government records. Using police and hospital reports from across the state, reporters pieced together the first comprehensive list of injuries and violent attacks inside Florida’s mental institutions.
The newspapers found:
[1.] Over the past five years, at least 15 people died after they injured themselves or were attacked by other patients….
[2.] Staffing shortages are so acute that violent patients wander the halls unsupervised. Employees are left alone to oversee 15 or more mentally ill men. Sometimes they carry no radio to call for help, and the nearest guard is in another building or on another floor.
[3.] Even when patients are placed under special watch, they have been able to swallow batteries and razor blades or hoard weapons to use on other patients.
[4.] Florida has no statewide minimum staffing requirements. And there are virtually no repercussions for administrators, even when someone dies….
[5.] At least three people died because hospital workers took too long to call 911. Some employees say they felt pressure not to call paramedics because of the expense. Others say they were required to track down a supervisor first, leading to delays….
Most patients are not hardened criminals or deranged killers. They struggle with illnesses that require daily treatment and have no other place to get it. Many are suicidal and have not threatened anyone but themselves. Mental hospitals are filled with people who hear voices, who see visions and who can’t control their actions….
Florida now trails many other states when it comes to workers on duty, with about half as many per patient as Washington and one-third as many as North Carolina. The nation’s third-largest state–and one of its richest–now spends less per capita on forensic mental hospitals than 42 others. It ranks 49th in total spending on all services for the mentally ill, according to the National Association of State Mental Health Program Directors….
At South Florida State Hospital, a state-funded mental institution run by a private company in Broward County, doctors told their bosses in July 2012 that patients didn’t have enough food to eat and were picking through trash cans for their meals….
As the state cut mental hospital staff and demanded more work from those few who remained, employees found one easy way to save time: They stopped checking on patients….
Since 2009, at least seven people died after staff members missed a safety check or broke other hospital rules. One patient was left alone in a scalding bath for so long his skin came off when workers tried to revive him.
Under Florida law, DCF [Department of Children and Families] can withhold information about people who die in its care, so long as the agency decides no employees were to blame….
In the name of patient privacy, the state has built a wall of secrecy around its mental hospitals, making it nearly impossible to track how they respond to abuse, neglect and carelessness by government workers….
Like everyone else, mental patients have a legal right to keep their medical records private.
But hospitals also use those privacy laws to make it harder to get information about unscrupulous or inept employees. Even parents can be denied information when their adult child is injured or killed in the state’s care….
Since 2009, at least 55 people died while in the care of a Florida mental institution.
State investigators concluded that four resulted from abuse or neglect.
But the Times/Herald-Tribune found four additional cases…where police reports or autopsy records show a patient died after workers made mistakes or delayed calling 911….
About 30 years ago, Florida passed a law that requires people to report abuse of the elderly and disabled. To protect victims and witnesses, the law says their names must be kept secret in abuse reports.
But the wording of the statute allows state officials to withhold far more than that.
“In order to protect the rights of the individual or other persons responsible for the welfare of a vulnerable adult, all records concerning reports of abuse, neglect, or exploitation of the vulnerable adult … shall be confidential,” Florida Statute 415 reads.
According to DCF officials, that means the agency can’t name workers who have been accused of abusing or neglecting the mental patients in their care….
To get a complete picture of injuries inside Florida’s mental hospitals, the Times/Herald-Tribune spent a year gathering documents from police agencies, court clerks and medical examiners across the state.
Even then it was impossible to find details on every death or major injury….
When the Times/Herald-Tribune asked to visit the hospitals, officials at Florida State Hospital and at Apalachicola Forest Youth Camp gave closely monitored tours of areas away from patients. They would not allow patients to be interviewed or photographs to be taken inside. None of the other hospitals allowed reporters on their grounds.
The top administrator at each of Florida’s six largest institutions declined to speak with the Times/Herald-Tribune.
Part 3, In the end, it wasn’t Anthony Barsotti’s demons that killed him, 5 November 2015:
Anthony Barsotti looks on the verge of death. His skin is ashen, his face gaunt. His mouth gapes as he stares at the ceiling, sporadically sucking in breaths.
Three hours earlier, Anthony was a physically healthy 23-year-old living in the state’s care at a Gainesville mental hospital.
Then he took a swing at another mental patient and a hospital orderly launched him head-first into a concrete wall. Workers at North Florida Evaluation and Treatment Center have a good chance to save his life this night in July 2010.
Instead, as hospital security cameras roll, they make one mistake after another….
In 2009, hospital administrators eliminated bed restraints and drastically reduced the practice of secluding unruly patients, all part of a national movement away from restraining mental patients. State regulators track each time a patient is placed in restraints, and hospitals that do it too often can be deemed out of compliance.
For Anthony, that means free movement around the hospital, despite the fights he starts.
At 5:07 p.m., Anthony leaves his room to watch TV….
Anthony watches the man he’d fought with three hours earlier walk into view and pause in front of the television.
At 5:08, Anthony lunges.
His feeble swing glances off the right ear of the man, a 49-year-old paranoid schizophrenic.
Henderson [an employee], 6-foot-1 and 200 pounds, is…standing in the back of the room. In an extreme reaction that state investigators would later label an “excessive use of force,” he rushes at the 127-pound Anthony and shoves him.
The crack of Anthony’s head on the concrete wall is so loud that another patient sitting nearby grabs his own head…. Anthony collapses in a heap on the floor.
Supplementary information: Susannah Nesmith, How two Florida papers partnered for a harrowing probe of state mental hospitals. Columbia Journalism Review, 5 November 2015.