AUGUSTA, Maine - An independent consultant says Riverview Psychiatric Center fails to adequately meet the needs of all patients, and therefore violates certain provisions of a consent decree. The consultant's report finds that Riverview has safety issues due to a lack of individualized treatment and inadequate staffing. Patient advocates say the problems need to be addressed but the hospital is improving.
It was Daniel Wathen, the Court Master who oversees the consent decree, who asked for the report. Wathen says it provides a good snapshot of Riverview, which lost federal certification - and funding - about a year ago. Wathen says the number of patients with acute mental illness has increased in recent years but staffing levels haven't.
"There are some very good people over there, and it wouldn't be working as well as it does if it weren't for them," he says, "but you need more very good people."
The report, by consultant Elizabeth Jones, found that staff often have to float to different units of the hospital. The problem is these staff often fill in in the more acute units where they're unfamilar with the patients, and that creates safety issues.
Jones says there's also a lack of staff understanding of the "Recovery" treatment model, where patients have an active voice in their treatment. Helen Bailey of the Disability Rights Center agrees. "They have a ways to go between talking about how clients participate in their plans, and the way in which that's carried out," Bailey says.
Jones also found that while staff recognize reducing the use of seclusion and restraints is a priority, pro-active alternatives are not consistently used. The report says a particularly troubling violation of the consent decree was the failure to report abuse of patients with pepper spray and Tasers in 2013. These incidents happened under previous leadership, but Daniel Wathen says they must still be addressed.
"It points up a need to impress upon staff that every member of the staff over there has an obligation to report so that doesn't happen again," he says.
Riverview Superintendent Jay Harper says the report supports the need for actions that are already on the table. "She didn't find anything new that we didn't know about," he says.
Case in point: The need to reintegrate the Lower Saco Unit with the rest of the hospital, which happened just this week. Lower Saco serves the most acute forensic patients and was separated in an attempt to satisfy the concerns of federal regulators. But Harper says it created more harm than good. Patients couldn't access Riverview's gym, cafeteria, or treatment mall and spent much of their days idle and bored.
"It restricted patients. It restricted staff. It restricted all of our assets we could play for patients benefit and recovery," Harper says.
Both Helen Bailey and Court Master Daniel Wathen say the concerns brought forth by the report are valid, but also feel Riverview is on the right path towards improvement. It's a process that will take time, says Wathen.
