State tightens rules for mental-hospital outings after $37,000 search

Phillip Arnold Paul

By Christine Clarridge

Seattle Times staff reporter

The escape of a mentally ill patient during a field trip to a county fair in September has prompted the state Department of Social and Health Services (DSHS) to adopt stringent new rules on which patients can go on outings from the state’s mental hospitals.

Forensic patients — those judged criminally insane — will not be allowed on field trips unless the patient has been granted a conditional release by the courts that is supported by the hospital and the patient’s treatment team.

In addition, law enforcement and the patient’s victims must be notified in advance of the field trip, according to the changes announced Thursday by DSHS.

Field trips also will be limited to no more than four patients at a time and hospitals will be required to keep up-to-date photographs and clothing descriptions of the patients.

“Public safety should always be our top priority,” said DSHS Secretary Susan Dreyfus. “These recommendations will help ensure that.”

The panel that recommended the changes is also suggesting the state transfer all criminally insane patients from Eastern State Hospital to Western State Hospital in Pierce County, where a secure, separate, locked-down facility is available.

The recommendation will be investigated, according to Richard Kellogg, director of the state’s Mental Health Systems and supervisor of the state hospitals.

The panel was created to review security at the state’s three mental hospitals after the escape of Phillip Arnold Paul, a mentally ill patient at Eastern State Hospital who slipped away during an outing to the Spokane County Interstate Fair on Sept. 17.

Paul is one of approximately 194 mentally ill people who have been charged with a crime but found not guilty by reason of insanity and sent to the forensic units at one of the state hospitals.

The hospitals also treat people who have been civilly committed for treatment and people who have been charged with a crime and sent to the mental hospital to have their competency restored. The hospitals are overseen by DSHS.

Paul was committed to Eastern State Hospital after being found not guilty by reason of insanity in the 1987 slaying of an elderly neighbor in Yakima County.

He was on a hospital-sanctioned field trip with 30 other patients and 11 staff members when he slipped away. His disappearance was not reported to law-enforcement authorities for nearly two hours.

A massive manhunt ended three days later when Paul surrendered to police near Goldendale, Klickitat County, about 180 miles from the fair.

His escape — and the hospital’s practice of allowing criminal mentally ill patients to go on field trips and outings — drew sharp criticism from Gov. Chris Gregoire and Spokane County Sheriff Ozzie Knezovich.

The sheriff has asked the state to reimburse the county more than $37,000 for the cost of the search.

After the incident, the CEO of Eastern State Hospital, Hal Wilson, resigned one month before he was scheduled to retire.

All field trips were temporarily canceled and Dreyfus convened the State Psychiatric Hospital Safety Review Panel to look at security and safety policies and practices.

According to the panel’s review, a number of policy discrepancies and staff errors contributed to Paul’s escape.

The review found that many hospital policies were outdated or had not been followed. The panel also found there existed a culture of friendliness between patients and staff members that may have led to poor supervision.

In addition, the review found, there was no designated leader on the field trip, the staff had not planned for a possible escape and it had not been clearly told to call 911 in the event of a security incident.

Despite the negative attention focused on the state hospitals, the “disturbing incident provided an opportunity to recommend positive, and doable, changes,” said Kellogg.

In addition to the already implemented changes, the state will look at the possible creation of permanent independent Psychiatric Security Review Board that could provide more oversight and counsel on matters relating to forensic patients.

Among those who served on the panel that reviewed the Paul incident were mental-health advocates, a state Department of Corrections official, King County Prosecutor Dan Satterberg and Knezovich.

Christine Clarridge: 206-464-8983 or cclarridge@seattletimes.com

http://seattletimes.nwsource.com/html/localnews/2010536481_escape18m.html

Advertisements

State considering criminally insane patients move

Eastern State Hospital
State considering criminally insane patients move

The state is considering moving all criminally insane mental patients to Western State Hospital in the wake of an escape from Eastern State earlier this year, a report released Thursday said.

By NICHOLAS K. GERANIOS

Associated Press Writer
SPOKANE, Wash. —

The state is considering moving all criminally insane mental patients to Western State Hospital in the wake of an escape from Eastern State earlier this year, a report released Thursday said.

Eastern State may be unable to safely deal with the most dangerous patients in its forensic unit, and consolidating people found not guilty by reason of insanity at Western State could save money and should be studied, the report from the Washington State Psychiatric Hospital Safety Review Panel said.

“This approach would need to be weighed against the potential for an adverse impact on families,” the report said. “Local work force impacts would also need to be considered.”

The report, obtained by The Associated Press, was commissioned by Department of Social and Health Services Secretary Susan Dreyfus after the September escape of Phillip Paul during an outing to the Spokane County Interstate Fair. Paul was committed in 1987 for the slaying of a Sunnyside woman. He was recaptured without incident near Goldendale three days after escaping.

The department will immediately adopt new controls on how forensics patients – meaning those who enter mental hospitals as a result of being found innocent by reason of insanity in criminal trials – are selected for field trips off hospital grounds, Dreyfus said.

“Public safety should always be our top priority,” Dreyfus said. “These recommendations will help us ensure that.”

Under the new policies:

-Only forensic patients who have been cleared for conditional release by the courts can go on field trips.

-Law enforcement agencies will be notified in advance of field trips, along with notification of victims or victim families who have requested notification.

-Field trips will be limited to no more than four patients at a time. Paul was among 30 patients taken to the fair.

-Mental hospitals will maintain up-to-date photo files of all forensic patients, with descriptions of clothing worn on the field trip.

-Any escape from a field trip will be immediately reported to 911. Paul was gone for more than an hour before authorities were called.

The review panel found that Eastern State policies and procedures were out of date and poorly organized; that Eastern State staff were not documenting risk assessments as required by policy; and that the hospital in the Spokane suburb of Medical Lake generally did not pay sufficient attention to safety and security issues.

The panel recommended an immediate review and update of Eastern State policies and procedures.

Eastern was ordered to stop mingling civil and forensic patients.

The panel did not endorse legislative action to create a “guilty but mentally ill” verdict, but it did review and endorse creation of a Psychiatric Security Review Board like one that exists in Oregon. That board acts as a second layer of authority for decisions involving all forensic patients.

Security experts from the Department of Corrections are still visiting both Eastern and Western state hospital campuses to review security.

The panel did not study or recommend staff discipline at Eastern State Hospital, where the chief executive officer has resigned. Dreyfus said the Washington State Patrol has been assigned to review staff roles during the escape.

Following the escape, all field trips were suspended at both hospitals. Dreyfus said field trips will be “carefully reinstated.”

The report: http://www.dshs.wa.gov/pdf/EA/121509SafetyReview.pdf

http://seattletimes.nwsource.com/html/localnews/2010532585_apwamentalinstitutionescape1stldwritethru.html