Texas and Its Institutions

These are some of my thoughts while reading this article. My thoughts, while not expert, are those of one who has both worked in the 'system' that cares for those with developmental disabilities and was shortly in the system as one receiving psychiatric care in large facilities.


Texas lambasted over care of mentally disabled
Justice Department accuses state of violating patients’ constitutional rights

DENTON, Texas - For more than a century, thousands of mentally disabled Americans were isolated from society, sometimes for life, by being confined to huge public hospitals.

In at least one place, they still are.

Texas has more mentally disabled patients in institutions than any other state, and the federal government has concluded that the state’s care system is stubbornly out of step with modern mental health practices.

For the third time in three years, the criticism has attracted the attention of the Justice Department, which on Tuesday accused Texas of violating residents’ constitutional rights to proper care.

Investigators found that dozens of patients died in the last year from preventable conditions, and officials declared that the number of injuries was “disturbingly high.”

In addition, hundreds of documents reviewed by The Associated Press show that some patients have been neglected, beaten, sexually abused or even killed by caretakers. Inspection reports also describe filthy rooms and unsanitary kitchens.

I wisht that I could say this sounds like a huge exaggeration, but... And these are the incidents that were reported. So much goes unreported.

The American Association on Intellectual and Developmental Disabilities says large care facilities — usually those with at least 16 residents — “enforce an unnatural, isolated, and regimented lifestyle that is not appropriate or necessary.”

This is true. Can you imagine living your life with 16, 45, 100, 300 other people? These kinds of facilities create a class system, perhaps better described as a caste system, with the staff being known as higher and better than, while those residing in facilities are lower and 'less than'. This (false) difference gets imprinted on both the soul of a resident and a staff member, which only the redemptive truth of God regarding one's true identity can remove.

Federal law requires the mentally disabled to be treated in “the most integrated setting” possible — a factor that led to the Justice Department rebuke of Texas.

Integrated, meaning community integrated, and least restrictive. This is a right of those receiving developmental disability services. There are, or can be created, community-based programs for those even with the worst behavioral issues and the most profound medical concerncs.

...critics allege that “warehousing” patients in large institutions invites abuse. Patients are isolated from their families and communities, making regular contact with loved ones more difficult. And caretakers often get overwhelmed by the large numbers of patients, Garrison-Tate said.

This is true. Even the person who loves those s/he is caring for and believes s/he is doing his or her life's work, can become frustrated and succumb to abusive behavior.

In Texas, officials verified 465 incidents of abuse or neglect against mentally disabled people in state care in fiscal year 2007. Over a three-month period this summer, the state opened at least 500 new cases with similar allegations, according to federal investigators.

An AP investigation earlier this year revealed that more than 800 state employees have been fired or suspended since the summer of 2003 because they abused, neglected or exploited mentally disabled residents.

A side note- did ya notice this artcile says that the employeew who abused those in their care were fired or suspended? Why no mention of criminal charges?

And in the one-year period ending in September, as many as 53 deaths in the facilities were due to potentially avoidable conditions such as pneumonia, bowel obstructions or sepsis, the Justice Department said.

53 people- real people.

Some families tell horror stories of their loved ones in the state facilities. For instance, Michelle Dooley said her son spent three months in the Austin State School, which she described as a place of “dingy yellow floors and patients running around without any clothes on.”

During his time there, he refused to leave his bed and often languished in his own excrement, she said.

Dooley eventually moved her son into a group home in Denton where treatment costs average about $50,000 per year — roughly half as much as the costs at state schools, Garrison-Tate said. Medicaid often picks up most of those costs.

“It was just horrible,” Dooley said. “If he goes back to a state facility, he will shut down and die.”

Speaks for itself.

Other families say they are happy with the state care.

Neil Davidson said his daughter Susan, who has cerebral palsy and is mentally retarded, has flourished during her 10 years at the Lubbock State School.

“I’m very impressed with the level of care she has received,” Davidson said. “As far as I am concerned, it’s Mr. Rogers’ neighborhood. Everybody is looking out for everybody else.”

I have no doubt that some of these facilities may provide some amount of good care. However, even the best institution or large facility is no comparrison to home. And if a home-like environment, such as one's own apartment or a group home is an option- why the heck not?

A visit to the Denton State School, the largest in Texas, reveals a sprawling campus spread across well-kept lawns. Superintendent Randy Spence described the place as a “happy, homelike atmosphere.”

Ha! 'Homelike'- whose home?

“The vast majority of our employees love the people they work with,” said Cecilia Fedorov, another spokeswoman for the Department of Aging and Disability Services. “They think of them as extended family.”

But Denton is also the site of Texas’ most notorious case of state school abuse.

In 2002, a care worker repeatedly kicked and punched a resident in the stomach and groin. Haseeb Chishty nearly died after that beating. He is now confined to a wheelchair and unable to feed himself or use the bathroom.

“It got to the point where it was fun beating him, torturing him,” said former care worker Kevin Miller, who is now serving 15 years for aggravated assault.

In a statement videotaped by Chishty’s lawyer, Miller said he and many of his fellow care workers used methamphetamines, cocaine and Oxycontin on the job.

Brokeness attracts brokeness. Many, if not most who are drawn to care for people with disabilities, have themselves struggled with 'issues' that virtually all with disabilities have struggled with- abuse, rejection, feeling 'different'. Unfortunately, many of those employees have not resolved their 'issues', and therefore, this case of assault and torture is a result.

Many of the institutions are large employers in small towns, and they often pay more than other jobs in rural areas. Lawmakers fear taking action that would lead to layoffs, Garrison-Tate said.

"I'm sorry, we have to keep the system of institutionalization of some so others can have a job." Is that it? I'd imagine, if these facilities close, these empolyess could get a job in the comminty programs. These people would still need care, after all, and, thus, need caregivers? Am I being too simplistic?

“Even if we said we wanted to close all state schools, the community resources aren’t there at this time,” said state Rep. Larry Phillips, chairman of a legislative committee studying the facilities.

So, what are you doing about that?

Kelly Reddell, the lawyer whose client’s son was beaten nearly to death, said the state is not doing right by its mentally disabled.

“The very nature of the institutional setting, I think, creates the environment for the abuse to take place,” she said. “How in the world can you think this system is the best and it makes sense?”

Time for change is a long time comin'.

Pictured at right, Haseeb Chishty, the man severely beaten by his caregiver at Denton State School, with his mother