Group probes mentally ill in nursing homes

NEW LONDON, Conn. --An advocacy group is investigating the placement of the mentally ill in nursing homes to determine if Connecticut is violating state and federal laws.

The Judge David L. Bazelon Center for Mental Health Law, working with state groups, is focusing on nursing home residents with psychiatric disabilities who have not exercised their right to court hearings or are in locked wards without proper psychiatric care.

The organization, based in Washington, D.C., also is looking into whether Connecticut has a plan to place the mentally ill in community settings.

"We are looking into the situation in Connecticut because there is such a large number of individuals in nursing homes and also because of the existence and use of these locked units," said Karen Bower, a Bazelon center lawyer who is leading the investigation.

More than 2,700 people with psychiatric disabilities live in nursing homes in Connecticut, and "in all likelihood that's a low estimate," said Wayne Dailey, spokesman for the state Department of Mental Health and Addiction Services.

A survey by the state's Office of Protection and Advocacy for Persons with Disabilities two years ago found 1,268 psychiatric patients living on locked wards. Some are referred by the mental health department, but most are discharged from psychiatric hospitals, emergency rooms or from private homes, often with the approval of a guardian or conservator.

Once residents, who are as young as 18, are placed in nursing homes, their care is monitored by the state Department of Public Health, which focuses on their physical, not psychiatric, treatment.

"Connecticut has not begun to even seriously consider that it needs standards and regulations for these units," said Jan VanTassel, executive director of the Connecticut Legal Rights Project, which is working with the Bazelon center.

Representatives of Bazelon have been working with the office of protection and advocacy and the legal rights project for the past several months, interviewing people with mental illness living in nursing homes.

"We are talking to people and learning about how they wound up in the nursing home and whether or not there is any interest in leaving the home and being in a more community-based setting," Bower said.

According to state law, no one can be committed to a "hospital for psychiatric disabilities" without a hearing before a judge, the right to legal counsel and the right to cross-examine witnesses. The law also says patients who are committed have the right to an annual court review of their status.

Such a review is not available to the mentally disabled in nursing homes.

The Bazelon center is considering a lawsuit against Connecticut over the issue of the mentally ill in nursing homes, but Dailey said legal action is not necessary.

State officials are studying the possibility of using Medicaid money to move residents out of nursing homes. A report is due to the General Assembly in January.

"Right now I think there's reason for optimism to think the issue might be addressed without legal action," Dailey said.


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