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In one undated document written by Western State’s current director, Jack Barber, Chumil is described as a patient whose demands overwhelmed the hospital’s staff.
“The focus of the staff is primarily on Mr. Chumil, around whom the entire operation is revolving. It is not clear to me how much more of this can be tolerated without a very major issue developing, with a loss of control by the staff, a severe injury, or a massive loss of staff,” the memo reads.
It then lays out a scenario of decreased attention to Chumil by establishing a plan that is “sufficiently restrictive that it restores control of the ward to the staff.”
“I think when there is a degree of crisis which has been building and has now fully arrived, ‘cutting our losses’ is simply all we can do,” Barber wrote.
Gulotta said the memo appears to set up Chumil’s isolation from the rest of the hospital’s population, ending a pattern of shackling or temporarily secluding him for his erratic behaviors.”
It may seem to some outsiders that this case is only about one patient in Western State Hospital and one case of founded violation of his human rights (see eariier posts on Western State Hospital and Mr. C.). But what I have observed and learned is that the ongoing violation of this one patient’s rights in such an egregious manner has infected the entire institutional culture of Western State Hospital. Staff are infected by the sense that anything less than the total loss of freedom of Mr. C. is not such a big deal and one Western State psychiatrist has been going around the state of Virginia showing a film of a former patient stating that a week in restraints ( a violation of state and federal regulations on the use/length of use of restraints on its face) was good for him. This at a time when all psychiatric hospitals are supposed to be reducing the use of restraint and seclusion and viewing it as a treatment failure. But of course in comparison to 20 years in seclusion, a decade or more of those in restraints 24/7, a week does not seem like much does it? Even if it is illegal under Virginia law. So why not boast about it if you are a psychiatrist at Western and see that the state and everybody else will let one person stay in seclusion fed through a hole in a door for years on end?
Patients are infected by being aware of Mr. C’s treatment. Some are scared it could happen to them, some distance themselves out of protection and see him as less than human thus identifying with the staff who oppress them. This will leave lingering scars on all these patients.
Staff feel a need to defend this horrible long lasting situation to the point where they feel free to violate confidentiality and once they feel free to do that in one case, it spreads to other patients who are not Mr. C. and we have staff that just does not get that they have a legal, moral, professional and ethical obligation to keep the confidentiality of patients from outsiders no matter what.
Senior staff have reacted by re-defining reality to make themselves more comfortable in ways that pervert the very concepts of dignity, respect, recovery and human rights. One senior staff told me years ago that other patients were “jealous” of Mr. C’s living situation! If she can say and believe that, how must this situation have infected her ability to see Western State Hospital patients as human beings like herself?
It is too simple to point fingers at one person although it is tempting to place sole blame on the psychiatrist who started this horror at Western. What we have here is an entire institution that has been infected with authoritarianism, dehumanization of patients, disregard for the human rights rules and regulations and disregard for confidentiality. We have something approaching the infamous Zimbardo fake prison experiment, but he closed that experiment down, this has been going on for 20 years.
I believe this infection has spread beyond the walls of Western State Hospital as well. When conditions are this awful in one hospital, real but less mind boggling human rights violations in other hospitals and other licensed programs in Virginia do not have the same impact and spur the same impetus to reform on our Protection and Advocacy agency and others whose role it is to protect and advocate for people who use our mental health system.
Who will have the courage to step in and take steps to stop the infection at Western State Hospital from festering and spreading? Commissoner Reinhard? Governor Kaine? The Department of Justice? Who?
