Minnesota’s troubled psychiatric hospital in St. Peter has a new medical director, a psychiatrist who helped lead the dramatic turnaround of a renowned mental facility in Washington, D.C.
Dr. KyleeAnn Stevens, 39, was director of forensic psychiatry at St. Elizabeths Hospital, a once-beleaguered facility that until recently was under federal investigation for dangerous conditions and poor patient care.
Her appointment, effective last month, is expected to bring significant changes to the Minnesota Security Hospital, which has struggled with many of the same problems that bedeviled St. Elizabeths a decade ago. These problems include frequent outbreaks of violence, lapses in patient care, demoralized staff, and high turnover of hospital leadership.
Stevens was part of a team of psychiatrists that transformed St. Elizabeths — known in Washington as “St. Eve’s” — into a national model of innovative psychiatric care. The turnaround involved a cultural shift toward treating people as patients with individual treatment needs, rather than as criminals, according to former hospital administrators.
“It’s safe to say that [Stevens] has been exposed to some very sick people,” said Dr. Roger Peele, former head of psychiatry at St. Elizabeths. “Anyone who has worked at St. Eve’s for very long has seen just about everything.”
In an interview, Stevens said she planned to carry through reforms already underway at the hospital, including a heightened focus on patient-centered care and a continued reduction in the use of punitive measures such as restraint and seclusion. The Minnesota Security Hospital, like St. Elizabeths, treats patients deemed by the courts to be too dangerous to be released to the community.
“We really want to focus on proactive approaches to managing symptoms to make sure patients are safe and feel safe,” Stevens said.
Her appointment comes as the Department of Human Services, the state agency that oversees the mental hospital in St. Peter, embarks on a wider reorganization of state services for vulnerable populations.
The agency announced plans Thursday to create a new division that will oversee services for people with disabilities and mental illnesses, as well as alcohol and drug abuse services. The yet-to-be-named division will be led by Jennifer DeCubellis, a Hennepin County administrator known for her pioneering efforts to integrate medical and behavioral health care with social services.
‘Horrible, just horrible’
Stevens comes from a mental hospital that, as recently as a decade ago, had become a symbol of America’s crumbling infrastructure for treating people with mental illnesses. Established by Congress in 1852, the hospital had fallen into such disrepair that plastic sheeting covered many of its windows and hallways sometimes smelled of urine.
“It was horrible, just horrible,” said Mary Nell McGarity Clark, an attorney for University Legal Services, which sued the District of Columbia in 2005 to force improvements at the facility.
The District of Columbia’s only public mental hospital, which still houses John Hinckley Jr., the man who tried to assassinate President Ronald Reagan in 1981, also struggled to protect patients from violence. In 2004, a 55-year-old patient diagnosed with bipolar disorder was stomped into a coma by another patient and eventually died. A few weeks later, another patient was beaten to death.
Facing a possible lawsuit by the U.S. Justice Department, the District in 2007 agreed to make a series of sweeping reforms. By August 2014, the hospital had made so much progress that its patient population had been cut by half and the Justice Department asked the federal court to discontinue the agency’s monitoring of the facility — effectively giving the hospital a clean bill of health.
“It’s not a wonderful place, because no institution is a wonderful place,” said McGarity Clark. “Still, it was a fairly remarkable turnaround.”
Though Stevens was careful to point out that she arrived at the hospital after the reforms began and cannot claim credit for them, she did play a role in their implementation. As director of forensic services, she supervised psychiatric and support staff and oversaw monitoring trends in admissions and quality control, among other duties.
“She comes from a major, major forensic [psychiatric] hospital with very substantial issues,” said Dr. S. Charles Schulz, chief of psychiatry at the University of Minnesota. “She should hit the ground running with good plans and ideas.”
Even so, Stevens faces significant challenges at St. Peter. Over the past year, the state hospital has been cited at least five times for rule violations and patient maltreatment. In January, a patient was beaten to death in his room by a fellow patient, and last month investigators found that the hospital subjected one patient to hours of inappropriate restraint and seclusion.
Stevens will be moving into her new role at a pivotal moment, just as the hospital hires dozens of new staff members and replenishes its psychiatric team. Since July, the hospital has hired more than 80 new people and two forensic psychiatrists. In addition, the state just established a 12-month fellowship program in forensic psychiatry with the University of Minnesota, which will provide the hospital with a pipeline of professionals once it begins in 2016.
Dr. Michael Farnsworth, a psychiatrist who served as medical director at the Security Hospital in the 1980s, said Stevens will be in a rare position to change the culture of the St. Peter facility. “There is an influx of young, new staff who need guidance and they need a strong leader who can set the tone for the facility,” Dr. Farnsworth said. “She will have her hands full.”
During Stevens’ time at St. Elizabeths, the hospital saw a dramatic reduction in the use of restraint and seclusion to control dangerous patients. Stevens made it clear this would also be a focus at the security hospital.
“We really want to focus on proactive approaches to managing symptoms … so that it never gets to the point of restraint and seclusion,” Stevens said.
Chris Serres • 612-673-4308