Serious problems persist at Wyoming's largest mental health facility four years after employees left an incapacitated woman on a couch without food, water or bathroom use for over 24 hours, according to two groups that provide legal and advocacy services to patients in need.
They include a suicide, attempted suicides, the sexual assault of a patient by an employee, patient-on-patient and patient-on-staff assaults, incorrect medicine dosing and excessive patient restraint, said representatives of Wyoming Protection and Advocacy and Wyoming Guardianship Corp., which act as legal guardians for dozens of patients at Wyoming State Hospital.
"There are systemic failures at the Wyoming State Hospital, some which have led to very serious and in some cases life-threatening conditions," Jeanne Thobro, director of Cheyenne-based Protection and Advocacy, told The Associated Press.
Many of the problems stem from inadequate staffing, Thobro said. The Wyoming Department of Health has difficulty recruiting psychiatrists, psychologists and other mental-health employees to the facility in Evanston, in far-western Wyoming, and statewide, she said.
Workers found patient Linda Gelok abandoned on a dayroom couch at the State Hospital in 2015. They needed her moved so they could work on a television. She reeked of urine and had an awkwardly kinked neck, court records said. Ants crawled on sores on her feet.
Wyoming Guardianship Corp., which represents Gelok, sued the state health agency on her behalf, alleging the poor treatment violated her rights. In October, the Wyoming Supreme Court ruled the case could proceed, saying its details "shock the conscience." The hospital settled for an undisclosed amount in December.
There has been little meaningful change there since 2015, Wyoming Guardianship Corp. Executive Director Emily Smith said.
"If this was just a one-time thing, I think everybody could agree when you have a facility of that magnitude, people make mistakes," Smith said. "That's not the place we're at right now with the Wyoming State Hospital."
Last June, a patient hanged himself with a bedsheet. In October, a certified nursing assistant pleaded no contest to charges he sexually assaulted a patient two years earlier. He had been tasked with watching her so she wouldn't harm herself.
Meanwhile, the Evanston Police Department in the past five years has responded to 82 reports of assaults and other incidents at the State Hospital serious enough to refer to prosecutors for possible charges, department spokesman Lt. Ken Pearson said Friday.
Other ongoing problems include relying too often on drugs and physical restraints to handle difficult patients, Thobro said, while having inadequate plans for releasing patients into the community. Protection and Advocacy clients often quickly cycle back to the State Hospital after release if there's enough room at the facility.
"You've got jails being clogged with people who've not committed a crime but have a serious and persistent mental illness and can't just be out and about in the community," Thobro said.
Local hospitals also often house people needing mental-health treatment, she added.
The Health Department denied records requests from the AP seeking reports on assaults and other incidents at the State Hospital. Department Director Mike Ceballos said his agency can't release such documents even in redacted form but noted federal agencies and the guardianship groups help ensure accountability.
The department wants to get way from treating the State Hospital as long-term housing for people who've been involuntarily committed by courts, said Ceballos, a former telecom industry executive appointed after Gov. Mark Gordon took office in January.
"Our job is to help them as quickly as we can, get them on their right medications, and then try to get them back out of this place, into another community," Ceballos said.
State health officials also cited significant remodeling and other State Hospital improvements due for completion next spring.
"The architect who designed that has experience with psychiatric hospital, so it's a very therapeutic environment, which is going to be immensely helpful along with much more efficient the layout, the openness," said Chris Newman, a senior Health Department administrator specializing in behavioral health.
The up to $150 million remodeling includes work at another state facility for people with significant disabilities, the Wyoming Life Resource Center in Lander.
The State Hospital currently houses 60 to 65 patients, down from the usual 80 to 85, amid construction work to make showers less conducive to suicide attempts.
Wyoming Protection and Advocacy represents 30 to 40 clients at the Wyoming State Hospital, while Wyoming Guardianship Corp. oversees 10 to 15. Protection and Advocacy is federally funded. Wyoming Guardianship Corp. relies on donations, client fees and a small amount of state funding.
Newman conceded inadequate staffing is a problem.
"Every time we talk about the staffing with any other health care facility, either in the state or across the country, everyone says, 'Get in line.' But we're really aggressively looking at ways to recruit and retain," Newman said.
The department plans to address improper dosing by switching to an automated medicine dispensing system used in many hospitals, she said.
Additional funding for mental health alone isn't the answer, Thobro said, partly because the State Hospital's current system directs money toward unnecessarily expensive treatment. Building up more community-based mental health options is a better approach, she said.
"It will save money in the long run," Thobro said.
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