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HomeNewsArchivesUndercurrents: Assault Report Illuminates Big Hole in Mental Health Care

Undercurrents: Assault Report Illuminates Big Hole in Mental Health Care

A regular Source feature, Undercurrents explores issues, ideas and events as they develop beneath the surface in the Virgin Islands community.

Last week a male inmate at Golden Grove Correctional Facility and Detention Center was charged with attacking a female corrections officer, allegedly hitting her about her head and face with his handcuffed hands.

For those who recognized the name St. Clair Daniels, the report brought back memories of one of the most gruesome, tragic and well-publicized events to occur on St. Thomas in the 1980s. Early one morning on Vessup Beach, in a seemingly unprovoked attack, a woman was killed with a machete, and shortly after, a man walking near the scene was also attacked and killed.

If ever they’ve thought of Daniels in the nearly 30 years since, most residents probably assumed he was stateside in a so-called forensics facility, that is, one designed to house psychiatric patients who have exhibited extremely violent criminal behavior.

Indeed, he was sent off-island in 1990, according to Juel Anderson, public relations director for the Bureau of Corrections, but at some point he was returned. She was unable to say when or why.

“He is not classified as a ‘prisoner’ but as NGRI – Not Guilty by Reason of Insanity,” she said.

The officer involved in the recent incident has worked at Golden Grove for about 23 years, Anderson said. She suffered a laceration to her face, but fortunately it did not require stitches.

Prison records indicate no prior incidents involving Daniels, except for threats, Anderson said. He is and has been housed separately from the rest of the prison population.

But without an actual forensics unit, that’s about the best the Bureau of Corrections can do.

The territory has been in violation of federal standards for decades, housing scores of psychiatric patients – some who are dangerous but many who are not – in its jails rather than in facilities designed to deliver care.

The situation is one of the major problems covered in consent decrees under which the Bureau of Corrections has been operating for more than 20 years, and which describe it as both potentially unsafe and decidedly unfair.

The lack of a forensics unit is also cited in a relatively recent report from a consultant hired to help the territory finds its way to providing adequate mental health care.

In December, Christopher Heginbotham of Synaptic Healthcare and Athena Consulting gave his draft report to the Consent Decree Commission on Mental Health. He recommended a complete overhaul of the current system, having the Health Department maintain oversight, but moving the actual delivery of services from the Health Department to a private or quasi-governmental entity.

Whether or not any of his suggestions for improving the delivery of other services are implemented, he said, the territory must rectify its lack of a forensics unit. He recommended a 10-bed facility.

The commission has been mulling over the consultant’s report for more than six months, unable to agree on which, if any, of the recommendations to accept. But according to the chairman, a compromise is near.

The commission itself grew out of a 2003 lawsuit brought against the local government, including the Health Department, by the Disabilities Rights Center of the Virgin Islands and other private groups on behalf of people with substance abuse and/or psychiatric health issues. The crux of the complaint was that the needs of the people were not being met.

Eventually the Court set the two sides the task of coming up with a plan to improve the delivery of mental health care, and the commission was created and given a deadline. Members of both sides were appointed to the commission and Liston Davis, then serving as a senator, was appointed the chair. Once it agrees on a five-year plan, the plan must be accepted by the governor and ultimately by the Court. It also will almost certainly require funding, which the Legislature will have to find.

“It hasn’t been easy,” Davis said in an interview last week. “We had 150 days – now going on four years.”

Davis said the commission had a budget of $50,000 for administrative costs and that included the cost of hiring the consultant.

Since the consultant’s draft report was issued, the sticking point has been his recommendation of privatization. “If you have statutory responsibilities, you don’t want to give them up too easily,” Davis said, adding that the “defendant” (the government) wants to maintain control.

The Health Department also wants to be the entity to monitor compliance with the Five-Year Plan, a position that he said is not acceptable to the “plaintiff.” On the plus side of reaching agreement: Both sides want to improve care for substance abusers and for psychiatric patients.

Davis said he thinks the commission will be ready to present its Five-Year Plan in August.

“We identified where the gaps were” in the system, he said. “They have agreed that some services would be out-sourced,” including case management, monitoring outpatient services and providing support services in settings like the Club House program, which helps psychiatric patients transition into jobs and independent living.

The consultant had suggested having the hospitals on each island take over much of the responsibility for care and Davis said the commission is leaning that way.

“St. Thomas is prepared to take over some of the services,” he said. “The Plan is calling for St. Croix to be opened.” The St. Croix psychiatric unit has been closed for more than a year and the hospital is struggling financially. Davis said the commission is trying to set up a meeting with the Center for Medicare and Medicaid Services about reopening the unit and the Legislature will have to find the necessary money.

And that’s not just for the hospitals.

“The plan is going to require a significant amount of staffing, which is going to require money,” Davis said. “The Legislature has to find the funding for the next five years.”

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