Release of 2nd patient from St. Peter is mishandled

  • Article by: PAUL MCENROE , Star Tribune
  • Updated: October 21, 2013 - 9:50 AM

Patient was ordered back after he repeatedly had sex with a vulnerable woman, records show.

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Minnesota Security Hospital complex, lower left, in St. Peter, Minn.

Photo: John Cross, Associated Press

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A psychiatric patient with a ­history of violence and inappropriate ­sexual behavior was discharged from the Minnesota Security Hospital last April, then delivered to a ­Minneapolis boarding facility where he repeatedly had sex with a vulnerable woman, according to documents reviewed by the Star Tribune.

The patient, Elliott Carroll, 44, was finally ordered back to St. Peter last month after Hennepin County authorities demanded he be given the ­forensic sexual evaluation that they said he should have had before his release, records show.

Carroll’s case is the second in recent months in which a mentally ill and dangerous patient was released from the security hospital without adequate safeguards. It also is the latest in a string of setbacks for state human services officials who are trying to improve patient care and management at the St. Peter hospital, which houses more than 400 of the state’s most ­dangerous patients and is the state’s largest psychiatric facility.

Officials at the state Department of Human Services say they don’t believe Carroll’s case reflected any errors on their part. They said the hospital is not necessarily required to evaluate a ­client’s sexual behavior before he is considered for discharge and said Carroll was not showing risk factors related to sexual activity at the time he was being considered for release.

Responsibility for supervising Carroll after his discharge, they said, fell solely to Hennepin County’s Adult Protection Unit and the licensed Minneapolis boardinghouse, Andrew Residence.

But Hennepin County officials insisted the department does share responsibility for supervising patients after their release, noting that state workers were involved in the case throughout.

“Along with the county, the state is responsible for the supervision of these clients in the community,” said Carmen Castaneda, a program manager at Hennepin County’s Adult Protection Unit. “The push is on to get these people out, but the problem is there are not enough appropriate community resources for persons who are mentally ill and ­dangerous.”

She pointed out that the state provides at least five “community support services” workers to assist the county in such cases, and at least one was directly involved in reviewing Carroll’s case after he violated conditions of his discharge, records show.

In a statement issued ­Friday, the department said: “It is unfortunate this placement failed, because it didn’t have to. Even though Hennepin County had all the information in the client’s file before the placement, we will find ways to work together so this doesn’t happen again.”

Records reviewed by the Star Tribune show that ­Carroll did not receive therapy for his sexual behavior before his release, and sources with direct information on Carroll’s treatment confirmed that no therapy was provided to him. His 2012 risk assessment states Carroll only had “some indications of sexually inappropriate behavior” when unstable.

He appeared stable

Carroll was committed to the hospital in 2005 after assaulting his juvenile girlfriend and threatening to kill people, according to state records. By late 2012, he appeared stable enough to be considered for release because he was not psychopathic, showed insights into his mental illness and understood the need to take medications, records show.

Last December, Dr. ­Steven Pratt, the state’s newly appointed medical director and hospital chief of staff, ­recommended Carroll’s discharge to a special review board. The risk assessment report noted Carroll’s “rather significant history of threatening and assaultive behavior, as well as some indications of sexually inappropriate behavior when decompensated.”

But that report makes no mention of Carroll receiving therapy for his sexual behaviors, stating only that his symptoms “are in remission with medication and treatment.”

After reading the risk assessment and attending the review hearing, the county’s protection worker did not raise any objections to placing Carroll in Andrew Residence, sources said.

But within a few weeks, it became clear that Carroll could not control his sexual behavior. He had sex multiple times with a woman and exposed himself to nurses who needed him to provide urine samples for drug testing, records show. Those incidents led the county ­protection worker to demand that Carroll undergo further evaluation.

“Mr. Carroll never ­participated in assessment or treatment for his problematic sexual behavior, nor was it known before his most recent risk assessment and Special Review Board hearing,” that protection worker later wrote.

Andrew Residence is licensed to treat mentally ill and dangerous persons. Currently, it has more than 200 residents, many with only a mental illness diagnosis who are not considered dangerous. In a statement, Andrew Residence said it followed all required protocols in Carroll’s supervision.

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