One
of Illinois' largest psychiatric hospitals dosed foster children with
dangerous combinations of mood-altering drugs, sometimes using the
medicines as "chemical restraints" to control youth who needed
counseling, according to a sharply worded new report by the University
of Illinois at Chicago's department of psychiatry.
The northwest suburban Streamwood Behavioral Health Center, which has
treated roughly 475 Department of Children and Family Services wards
since 2007, is "so understaffed as to be counter-therapeutic," the UIC
report said. Amid violent outbursts by young patients, hospital staff
resorted to extraordinarily high rates of emergency psychiatric
medications, physical restraints and seclusion, the report said.
DCFS Director Erwin McEwen reacted to the findings by angrily
criticizing Streamwood owner Psychiatric Solutions Inc., the nation's
largest for-profit behavioral health firm.
"Profiteering at the expense of the mental health of vulnerable
children will not be tolerated in Illinois," McEwen's statement said.
"PSI needs to develop a different business model if they want to
continue caring for our children. Unless and until this corporation
pays attention to children with the same fervor that they devote to the
bottom line, we will seek alternatives to reduce and eventually
eliminate our dependence on this provider."
McEwen added that DCFS intends "to fully implement the report's
recommendations." He said DCFS will seek probes from the state auditor
general to determine whether PSI overcharged the state, and from the
inspector general of the U.S. Department of Health and Human Services
in instances of alleged harm to youth.
The Streamwood facility said it will give a detailed response in the
coming weeks. But in a written statement, it called the UIC report
biased and said "many of the 'findings' in the report, including
allegations of understaffing and overuse of medications, are
exaggerated and misleading." The facility said "all medications
provided to our patients are at the direction of our physicians," and
the hospital fulfills "its mission of providing quality, compassionate
care."
DCFS commissioned the UIC team to examine conditions at state
psychiatric hospitals following a July 2008 Tribune investigation that
documented a series of sexual assault allegations at a sister PSI
facility, west suburban Riveredge Hospital. The U.S. Justice Department
also opened an investigation into Riveredge.
PSI, which operates 95 behavioral health care facilities nationwide,
dominates Illinois' youth treatment market. At Streamwood, the UIC
report said, treatment became "undermined or sidetracked by the
over-reliance on chemical restraints as the primary behavior management
tool."
Although Illinois law requires hospitals and doctors to secure DCFS
consent when prescribing psychotropic medicine to foster children,
Streamwood hospital last year stopped reporting prescriptions of
emergency medications to juvenile state wards to DCFS, the UIC report
said.
At PSI's adjacent residential facility, known as the John Costigan
Residential Center, emergency medication use was more than 30 times
higher than in other psychiatric residential programs serving a similar
population of troubled DCFS wards, the report said.
There were numerous medication errors at both the hospital and
treatment center, the UIC report said. In one incident, hospital staff
called a Code Blue after a 6-year-old boy was given twice the dose of
an anti-psychotic medicine recommended for his body weight, the UIC
report said. The child was rushed to an emergency room where he was
kept overnight and then released, the report said.
The Tribune reported last year that DCFS paid PSI at least $650,000 to
hold empty beds at the Costigan center for 38 wards who were being
treated next door at the company's Streamwood hospital. The UIC team
harshly criticized this "pattern of revolving-door hospitalizations
from the residential program," saying it put children through chaotic
therapeutic regimes.
dyjackson@tribune.com