In a state hospital, nowhere else to go 'Take me out of here': About 50 brain-injured patients in Maryland are suing the state to be placed in supervised group homes.

February 23, 1996|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

Late at night, when the phone rings, Eleanor Williams braces herself.

"Please take me out of here. Don't let them keep me here," pleads her son, Gary Williams, 34. He has lived at Clifton T. Perkins Hospital Center, a maximum security state facility in Jessup for the criminally insane, for seven years. But he isn't a criminal, and he isn't mentally ill.

He is the victim of a split-second tragedy -- a hit-and-run accident in 1980 that caused a traumatic brain injury, leaving him with little control over his impulses and few options. Mr. Williams is one of about 50 brain-injured people in Maryland who have been sent to state mental hospitals because there is nowhere else for them to go.

He and other patients are suing the state under the Americans with Disabilities Act, asking to be placed in supervised group homes. They say they don't belong in state hospitals whose staffs aren't trained to help them, where the crowded and noisy environment worsens their behavioral problems, where they are restrained for days and sometimes assaulted by other patients.

"I'm not bad. I'm a good man," Mr. Williams said. "I should be out of here. I should have a girlfriend. I can take care of myself. I can cook my own food. I can wash my own clothes."

The state pays $30,000 a year for him to attend a work program in Columbia on weekdays, but each night he must return to be locked in the hospital.

Across the country, countless other patients also find themselves living out their lives in mental hospitals while grappling with the knowledge of what was and what might have been -- vivid memories of a cool swim on a hot day, of the respect some commanded in their professions, of youthful aspirations forever denied after a car crash or a serious fall.

Each year, of the 2 million Americans who suffer traumatic brain injuries, one-third die and another third suffer permanent impairments, from seizures and headaches to short-term memory loss and mood swings.

A small number of the victims are left with behavioral problems such as constantly interrupting conversations, acting inappropriately with the opposite sex, stealing or hitting. That's because the part of the brain that controls impulse and inhibition -- and makes distinctions between right and wrong -- sits just behind the forehead and is particularly vulnerable in head injuries.

Mr. Williams, for example, used to bite his wrists and try to grab women's breasts. Most of that behavior has been controlled over the years, so now he remains institutionalized primarily because he needs help with basics, like being reminded to take showers.

Another victim kept trying to pet dogs -- despite the fact that the dogs were in moving cars. Bobbie Kemble, 24, improved during specialized treatment paid for by private insurance but worsened after spending several years in state mental hospitals, said her father, Robert Kemble of Myersville. His once fiercely independent daughter was hit by a motorcycle at 16.

'Very profound injuries'

"We are seeing more people survive with very, very profound injuries because of new emergency treatment. People are living who in the past would have expired," said George Zitnay, president of the Brain Injury Association of America, a national advocacy group. "If we have a policy in this country to save everybody, then we have a responsibility to provide them with the tools and the rehabilitation to lead a productive life."

When private insurance runs out, or a family can't handle an injured relative at home, an altercation with a sibling or a sales clerk, for example, may land a person in a state hospital. Often these patients are difficult to manage, have complicated diagnoses and need round-the-clock supervision. Community placements are scarce, state health officials say, and mental hospitals are the logical alternative.

But advocates and families say patients end up staying much longer than necessary and their conditions deteriorate.

A group in Connecticut has filed a class-action suit to push that state to provide appropriate services. Locally, the Maryland Disability Law Center (MDLC) has filed a lawsuit with Mr. Williams as the lead plaintiff, and attorneys expect the suit to get class-action status. Similar advocacy groups in several other states are also planning legal action modeled on the Maryland and Connecticut suits.

A few states, such as Massachusetts, have developed day programs, counseling services and, for those with the worst behavior, a specially designed locked unit staffed by trained personnel. Meanwhile, a bill has been introduced in Congress that would establish uniform reporting of injuries and force states to adopt plans to provide residential care and proper treatment.

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