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Gov. Mark Dayton said on Wednesday that "there is a crisis of patient abuse'' at the Minnesota Security Hospital in St. Peter, a hospital that has been battered in recent months by management turmoil, resignations of psychiatric staff and incidents of inhumane care.
Concluding an unusual firsthand tour of the hospital's psychiatric wards, Dayton said he endorsed the controversial efforts adopted recently by administrators to end unchecked patient seclusion and restraint practices.
During a two-hour visit, Dayton also met with about 300 employees, many of whom, he said, voiced confusion over the hospital's patient-care philosophy after years of mixing strict discipline with isolation in a prison-like setting.
Dayton said he left struck by the need for employees to be better trained in caring for the state's most volatile patients.
"I walked through all the wards, and I saw obsolescence. I looked at the seclusion room -- really obsolete," he said. "Hard walls, sharp edges on the benches, a very antiquated setting."
Dayton said the patients need a more humane environment and cited a bonding bill that would include a major overhaul of the hospital.
The governor's tour came the same day that the Minnesota Psychiatric Society sent him a letter expressing "grave concern about the current crisis" over conditions at the state's only facility for patients diagnosed as mentally ill and dangerous.
"We are concerned that administrative behavior has contributed to a counter-therapeutic environment and a culture of fear among the staff, leading to the resignation of essentially the entire psychiatric staff at the hospital," the society wrote.
Dayton and Human Services Commissioner Lucinda Jesson now face the challenge of developing new approaches in care for more than 375 patients committed indefinitely to the state's charge as mentally ill and dangerous while at the same time working with a group of psychiatric professionals who say that their expertise has been disregarded.
For the past five months, the hospital has operated under a cloud of problems, including the resignations of at least six psychiatrists and substantiated reports of patient maltreatment -- a situation that caused Jesson in January to place the hospital's license on conditional status for two years and fine it $2,000, the maximum allowed under state law.
"I think the abuse of patients was a crisis, the extreme measures that some took against these people," Dayton said in an interview following his visit. He said it was "unthinkable in this era" that a patient would be forced to endure such treatment.
The incidents occurred before Jesson's department hired a new administrator, David Proffitt, from Maine, to overhaul the treatment program.
"The points that Administrator Proffitt made to me are that we want people who come here to feel they're in a caring, supportive place that is not a substitute for prison," Dayton said.
Proffitt has mandated a minimum restraint and seclusion policy since he was hired in September.
Proffitt's tenure, though, has triggered a new set of challenges, including the resignations of several longtime psychiatrists who accused him of a combative and difficult management style. Today, Proffitt finds himself at the center of an investigation on whether he created a hostile work environment by allegedly intimidating doctors, yelling at them and making inappropriate sexual comments to nurses during a lecture. Several weeks ago, Jesson hired a Minneapolis law firm to conduct a workplace investigation at the hospital, and interviews with staff members are now underway.
Jesson's senior staff members have acknowledged that they must quickly rebuild and stabilize the upper tier of the hospital psychiatric staff.
In its letter to Dayton, the Psychiatric Society called the Human Services Commission's workplace investigation "off the mark."
"We are more concerned that the current environment impedes good clinical care ... and that because of that problematic leadership, the staff are unable to fulfill their mission."
Dayton said that during the tour he was drawn to recall his own experiences in 1968 working as an orderly-attendant at a ward in a New York hospital where psychotic patients were treated.
"What I heard today from the psychiatrists and the head of nursing is that their patients are making significant progress and are leading much more stable, healthier lives," he said.
"But one of the problems is that there is nowhere for them to go [after completing treatment]. We need to work with the Legislature to devise something where we can assure the public of their safety and security but also help people who are in here who deserve to live in a very supervised setting."
Paul McEnroe • 612-673-1745