In reform effort, state hospital will give families a seat at the table

Facing intense criticism from parents and patient advocates, the state's largest psychiatric hospital is preparing to give families much greater say in the treatment of mentally ill patients.

The move is part of a broad series of reforms at the embattled state hospital, which has struggled with staff turnover, incidents of patient maltreatment and serious security lapses.

Hundreds of parents, siblings and spouses of patients will get letters this week from the state Department of Human Services, inviting them to become members of the first-ever family advisory council at the Minnesota Security Hospital in St. Peter. The council will advise the hospital, which houses about 225 of the state's most dangerous and mentally ill patients, on everything from group therapy to patient security and room decor.

Problems at the hospital came to a head in January, when a patient was beaten to death in his room; in a scathing report, state investigators blamed the murder on poor supervision and a lack of engagement among some hospital staff with patients. The bloody killing prompted parents and advocates to intensify their demand for a seat at the table with hospital administrators and staff. "We feel like no one understands our children better than us," said Connie Kishel, whose son is a patient.

Because of the incident, the state extended the hospital's conditional license until December 2016, effectively keeping the facility on probation another two years.

The January death also galvanized state authorities to accelerate planned changes intended to improve care and make the facility less like a prison and more like a hospital.

Since July, the Department of Human Services has hired two forensic psychiatrists; a new medical director and a general psychiatrist will start by November. The state is also bringing in outside mentors and former patients to reshape care and to train staff on interacting with patients and de-escalating tense situations. By year's end, the hospital's entire staff will have been trained in person-centered planning, in which the patient directs the treatment.

"There is nothing better than to have outsiders look at us," she said. "You create a different environment when you have people who have that clients' perspective looking at you."

Parents and advocacy groups have long complained of the prisonlike atmosphere at the St. Peter facility, and of struggling to get even basic information about their children. The shock of learning that a loved one has been admitted to a mental hospital is often exacerbated, say parents, by the secrecy that surrounds their treatment and the lack of engagement with staff.

Sheila Novak recalled the first time she walked through the hospital's locked double doors.

After being screened with wands by security guards and being told to check her personal items into a locker, she was escorted to a small room where she was allowed to talk to her son through a glass window. She had to share the lone telephone receiver with her husband. "It felt just like a prison" she said.

Even later, when Novak was able to meet her son in the visitors' room without the partition, she was still observed by hospital staff. She and her husband were discouraged from embracing him, or even holding his hand, she said.

Kathleen Bischel Beddow said she struggled to communicate vital information about her son to medical staff at St. Peter when he was committed 11 years ago. She knew, for instance, that her son was highly sensitive to certain foods because of his Asperger's syndrome. But, she said, the hospital ignored his request for the few foods that he was capable of eating.

"I kept saying, 'He needs food! He's hungry!'," Beddow recalled. "But they were completely in the dark. They couldn't see it and they couldn't understand it and they didn't want to talk to me about it."

The idea for a family advisory council arose, in part, from an effort at Regions Hospital in St. Paul. In 2012, as Regions was opening a 100-bed mental health facility, it decided to reorient care so patients would get more support when discharged into the community. This meant gathering input from family members on every aspect of care, from the time they walked in the door to discharge into the community, said Gretchen Prohofsky, allied health manager at Regions.

Today, Regions has a 26-member family advisory committee that meets monthly. Representatives from every professional discipline at the mental hospital — including psychiatrists, psychologists, nurses, and occupational therapists — attend the evening meetings. The council has addressed a wide range of concerns, from making visiting hours more accessible for working parents to computer access.

"There is no agenda item that is off boundaries," Prohofsky said.

Chris Serres • 612-673-4308