Lawsuits seeks end to warehousing of psychiatric patients

HARTFORD, Conn. --More than 200 Connecticut psychiatric patients are forced to live in nursing homes, often in locked wards, when other locations would better suit them and be less costly, advocates for the mentally ill said in a lawsuit filed Monday.

The federal lawsuit, brought by the state's Office of Protection and Advocacy for Persons with Disabilities and the Bazelon Center for Mental Health Law, accuses Connecticut of violating the Americans with Disabilities Act and other federal laws.

Although the lawsuit focuses on patients at three Connecticut nursing facilities, OPA Executive Director James McGaughey said the implications extend far beyond those individuals and places.

"Institutionalizing people when they want to live in the community, and it is possible for them to live in the community with the proper supports, is a violation of their civil rights," he said.

About 3,000 of the state's approximately 27,000 nursing home residents have been diagnosed with serious mental illness, according to a draft version of a state task force report.

That report, due to be finalized and delivered to Gov. M. Jodi Rell and the General Assembly during the upcoming legislative session, estimates that several hundred of those patients could function well outside of the nursing homes -- at group homes or with family, for example -- if they receive the proper community-based services.

The practice of housing psychiatric patients at Connecticut nursing homes has gained attention in recent years, particularly after a 2003 incident in which 16 people died when a mentally ill patient started a fire at the Greenwood Health Center in Hartford. In Manchester in December 2000, a 23-year-old mentally ill man slashed an elderly resident's throat at a nursing home because he was upset the man had taken a cookie from him.

Advocates for elderly nursing home residents have raised concerns for years about the safety of blending frail, aged residents with younger, stronger people whose mental illnesses may cause unpredictable behavior.

To address those concerns, some nursing facilities have set up separate, locked "behavioral health care" wards -- one of the issues at the crux of the new lawsuit.

State Sen. Edith Prague, a Democrat from Columbia and co-chairwoman of the legislature's Select Committee on Aging, said Monday that neither group is well served by the current arrangement.

"What we have now is people with psychiatric problems not getting the services they need, mixed in with the elderly population that should be able to live quietly and in peace," she said.

David Dearborn, a Rell spokesman, said the governor and legislators are concerned about providing the appropriate care to people with mental illnesses, and continue to direct funding and attention toward the issue.

"On one hand, it is unfortunate that litigation was filed when the problem is already being addressed," he said. "On the other hand, the goal of OPA and other advocates is to affect change, so it's understandable but not necessarily helpful."

The draft report due to Rell from the Connecticut Mental Health Cabinet task force suggests asking the federal government to allow Medicaid money to help pay for community-based services for mentally ill patients who have "high discharge potential" from the nursing homes in which they have been placed.

The report also calls for annual evaluations of those patients.

"Presently, in the absence of ongoing monitoring, there is no means for determining whether a nursing home resident with serious mental illness might have improved to a point where he/she could be discharged," the report says.

Jennifer Mathis, a staff attorney at the Washington, D.C.-based Bazelon Center, said New Jersey, New York and Ohio are among other states who also place patients with mental illnesses into nursing facilities.

Connecticut stands out, however, both because patients are held in locked wards at some facilities, and because the Greenwood Health Center fire did not prompt the reforms expected by many advocates for the mentally ill.

"Many of us thought that Connecticut would finally see the light and begin creating the appropriate community services for people that they were inappropriately housing in nursing homes," Mathis said. "Instead, Connecticut seems to actually be going backwards."