Is patient care – or profits – the priority at privatized Montgomery County Mental Health Treatment Facility in Conroe?

By Ryan Meltzer ACLU of Texas Intern Last week, we ran a post that mentioned the grand jury investigation into the construction of the Montgomery County Mental Health Treatment Facility in Conroe. Apparently, the County didn’t publish any legal notices requesting bids from construction companies, as required by law, nor was there any evidence that the commissioners chose the “winning” company from a list of recommended, qualified developers. As it turns out, the facility’s problems didn’t end with the whiffs of corruption surrounding its construction. Now, the Austin American-Statesman and the Houston Chronicle are reporting that the Texas Department of Health Services has recommended levying over $100,000 in fines against the facility, stemming from severe shortcomings in the patient care provided by—you guessed it—GEO Care, a subsidiary of private prison operator GEO Group. The Department has tentatively reduced the fine to $53,000, but its decision is not final—and when you read the laundry list of violations, you’ll understand why. Since March 2011, the Department has inspected the facility three times, and each visit has turned up serious problems, ranging from unauthorized restraint and seclusion of patients to inadequate recordkeeping and failure to report grave patient injuries to the state. Some lowlights:

• Half of 50 incidents of patient restraint or seclusion were not supported by an “appropriate” physician’s order. The Department determined that there was a “significant lack of compliance with physician orders for initiating restraint.”
• The director of psychiatric nursing had only an associate’s degree, rather than the required master’s degree in psychiatric mental health.
• Classes designed to help patients recover were described as “bedlam,” leading patients to refuse attendance. (Echoes of the New York Times’ story on the halfway houses operated by Community Education Centers. For our previous coverage on CEC, see here and here)
• The hospital kept patients for months after they had been found competent to stand trial, and maintained excessively restrictive policies on phone use and personal property.
• While being held in seclusion for four hours, one patient threatened staff and repeatedly banged his head against his room’s walls, causing lacerations to both eyes and a bruise to his head. Staff did not attempt to help the patient—for instance, by employing mechanical restraints—out of fear.
• One patient seriously injured himself and then consumed fecal matter, but the incident was not reported to the state or addressed through the patient’s treatment plan.

The most disturbing part: Despite these deeply troubling findings, the Department is moving forward with its plans to privatize one of the 10 public psychiatric hospitals it oversees. Admittedly, the Department’s hands appear to be tied—the Chronicle reports that state lawmakers attached a rider to last year’s budget bill, ordering officials to privatize one state psychiatric hospital and generate at least 10 percent cost savings to the state. Laws like this elevate fiscal savings over human welfare, and evince a callous indifference to the care of the most vulnerable members of our society. Actually, no. Scratch that. The most disturbing part: As of last Thursday, the only company to bid for the contract was—that’s right—GEO Care. Tell your lawmakers that there are better ways to cut state costs than farming out prison and mental health care operations to profit-driven companies. Join our Community Action Network today!