Federal Report Criticizes Quality of Care for Adult Patients at Metropolitan State Hospital

Adult patients with mental illnesses at Metropolitan State Hospital in Norwalk "were often misdiagnosed, over-medicated and improperly restrained for weeks at a time," according to a newly released U.S. Department of Justice report, the Los Angeles Times reports. The report, which is based on DOJ investigators' visits to the hospital in June and July 2002, identified problems with improper use of medication, incomplete patient records and inadequate preparations for discharge. According to the report, between April 2001 and March 2002, 475 patient-on-patient assaults occurred at the facility, which typically holds between 800 and 900 patients. Most of the adults at the hospital "were committed to the facility by civil courts, sentenced to the hospital for criminal wrongdoing or placed there by counties across the state," the Times reports. DOJ has given the Department of Mental Health, which runs Metropolitan, until May to respond to the report, at which time state and federal authorities will start deciding how to solve the problems at the facility. If the negotiations are not successful, DOJ could "try to force improvements by suing the state under the Civil Rights of Institutionalized Persons Act," the Times reports. John Rodriguez, deputy director of long-term care at DMH, said that the department has hired a consultant to address the problems and that the hospital had begun a new program for patients to work with doctors to discuss rejoining the community (Hymon, Los Angeles Times, 2/25).

Following an investigation launched in June 2002, DOJ said in July that the facility's program for children and teenagers does not comply with the federal Civil Rights of Institutionalized Persons Act and is contributing to negative feelings among its patients. The investigation found that the facility, which houses 100 patients between ages 10 and 17, diagnosed disorders that patients did not have, failed to identify patients' actual problems, prescribed inappropriate medications, did not provide enough protection from other patients, inadequately supervised patients and may have compounded patients' psychiatric distress by keeping them in the hospital longer than necessary. The report also said that the insufficient supervision may have contributed to repeated suicide attempts and possible sexual coercion between patients under age 18 (California Healthline, 7/7/03).

Rodriguez said that the report gives too narrow a view of the facility, adding, "I don't believe we have large systemic problems that are putting patients in jeopardy, but you can always do a better job." The Times reports that a DOJ official speaking under condition of anonymity said that there was "anecdotal evidence that the hospital is making the necessary fixes -- but no firm proof." Dr. Rod Shaner, medical director at the Los Angeles County Department of Mental Health, said, "I think there's a sense the staff at Metropolitan Hospital is in the process of making significant changes, and there is evidence that they are doing everything they can to move in the right direction." Pamila Lew, an attorney with Protection and Advocacy, a group that represents patients at the facility, said that she "has concerns about the pace of change" at the hospital (Los Angeles Times, 2/25).