Legislators consider separating sexes in Md. psychiatric hospitals

Bill follows strangling of female Perkins patient, allegedly by male hall mate

March 16, 2011|By Yeganeh June Torbati, The Baltimore Sun

Maryland delegates will consider Thursday a bill that would separate men's and women's bedrooms in state psychiatric hospitals, a move that advocates contend would protect vulnerable women but that health officials say they need more time to research.

The bill would also require the hospitals to screen patients for risk of abusive behavior and report all instances of sexual abuse and harassment to authorities. The bill is spurred, supporters say, by last year's killing of a female patient on a coed ward at Clifton T. Perkins Hospital Center, a state psychiatric facility that houses the criminally insane. A male patient was charged in her death.

The Senate Finance Committee heard the bill this month, and the House's Health and Government Operations Committee is set to take up the bill Thursday in a hearing.

In interviews with women psychiatric patients in Maryland, "it's been universal for us that the females have an extensive history of abuse by men," said Laura Cain, managing attorney at the Maryland Disability Law Center, which has a federal mandate to oversee the treatment of mental health patients.

Coed housing, Cain said, gives potential abusers easier access to women's bedrooms, makes many of the women feel unsafe and may make it harder to treat their mental problems.

Officials at the Department of Health and Mental Hygiene object to the gender-specific housing requirement in the bill, and say they do not know enough about the effect that female-only units would have on care. They are requesting more time to study the issue, and say they could have all the data they need by the next legislative session.

"We're actually in agreement on the use of trauma-informed care principles and interventions in the state hospitals," said Dr. Brian Hepburn, director of the Mental Hygiene Administration, which oversees state psychiatric hospitals. "We just don't want to make a commitment at this point on how quickly we move ahead in terms of the single-sex units, because there are clinical issues we need to resolve, and there are obviously fiscal issues we need to resolve."

Hepburn stressed that the department "does not support same-sex units in psychiatric hospitals as a general standard."

"There may be times when it is appropriate to separate by gender, but again not as a general practice," he said. "As we understand it, this is not the standard applied in the private hospitals."

Supporters of the bill say the state has had plenty of time to study women-only wards, pointing to a 2005 study by MHA officials, hospital executives and advocates that concluded the health department should try gender-specific housing on a pilot basis, with an eye toward making it permanent policy.

"I expected they would take their own recommendations and move forward," said Del. James W. Hubbard, a Democrat from Prince George's County who worked on the issue at the time and is sponsoring this year's bill. "They're responsible for safeguarding these patients, and that's not happening."

Hepburn said the committee report was never made policy because hospital directors disagreed on its findings.

The push for change comes after the September strangling of Susan Sachs, who slept in a room two doors from her accused killer, El-Soudani El-Wahhabi, on a medium-security, coed ward at Perkins. El-Wahhabi, who had been sent to Perkins for the murder and sexual assault of a Baltimore woman, was videotaped entering and exiting Sachs' room on the night of the killing undetected by staff, and he later told police that he strangled Sachs.

El-Wahhabi had spent most of his time at Perkins in a maximum-security ward, but was moved to a less-restrictive ward two months before the killing. Sheilah Davenport, Perkins' chief executive at the time of the incident, stepped down in February.

The MHA launched a pilot, women-only unit at Perkins in late February, Hepburn said, for 17 patients in the maximum-security wing. Women make up about 20 percent to 25 percent of state psychiatric patients. The department intends to study the pilot, conduct a survey of female patients and research how private hospitals and other states house men and women, Hepburn said.

Sen. Catherine Pugh, a Democrat from Baltimore, is sponsoring the bill and said she believes it has the votes to move out of the finance committee.

"I don't think we have as much of a problem giving them some time to get the walls up, but we don't want to come back here next year fighting for a bill that should be implemented," she said.

Tight budgets are also coming into play, with the health department claiming in Senate testimony that implementing the bill would require "millions of dollars of physical plant renovations."

An analysis of the bill's fiscal impact by the Department of Legislative Services estimates the bill would cost at least $56,000 next year, to pay for hiring someone to train staff and ensure compliance, plus the cost of separating male and female bedrooms. Those "costs could vary widely" from hospital to hospital, according to the analysis.

The DHMH has absorbed a major portion of all state budget cuts in the past few years, according to the Department of Budget and Management figures. The cost-cutting was partially behind the closure of the Upper Shore Community Mental Health Center last year.

The National Alliance on Mental Illness of Maryland, which is supporting the bill, estimates the state has cut mental health funding by 4 percent, or $26 million, since 2009.



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