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Great Editorial on the Carney Situation from a Prominent Web Site Covering Mental Health Issues

When Things Go Wrong in Massachusetts, Fire the Employees, Not Carney Hospital

By John M. Grohol, PsyD

Founder & Editor-in-Chief

Mental health care in Massachusetts is sometimes a hit or miss proposition. Especially if you’re poor or indigent, or may present a danger to yourself or others.

For the 14-bed locked hospital unit at Carney — now owned by Steward Health Care — it apparently was such a “miss” proposition that they ended up sacking the entire staff. Yes, you heard me — all 29 psychiatric nurses and mental health counselors were let go about a month ago.

Meanwhile, Massachusetts continues to pay Carney Hospital to run its program, with all new staff.

Is it possible that 29 different professionals really were responsible for the four complaints? Or is this a perfect example of incompetent management and senior hospital executives covering their asses, and trying to put the best foot forward to keep the state’s lucrative, multi-million dollar contract?

Gee, I wonder.

The four complaints were serious and pointed to serious deficiencies in oversight and training at Carney:

State child protection investigators concluded that four of the complaints were valid, based on interviews and other information. In one case, a mental health counselor allegedly assaulted a 16-year-old female patient. In another, a counselor reportedly assaulted a 15-year-old male patient. One of those incidents involved a sexual assault, Carney officials said.

A third validated complaint, of neglect, involved an apparent relationship between two patients — a 15-year-old boy and a 16-year-old girl — indicating a lack of proper supervision on the unit.

The Department of Mental Health also investigated the three cases and found that staff “acted in a manner that was dangerous, illegal, and inhumane,’’ according to the agency’s letters describing the findings, which were obtained by the Globe through a freedom of in formation request.

The people responsible for these abuses should’ve already been fired. And not only fired, but brought up on criminal charges.

So who advised Bill Walczak, president of Carney Hospital, to make the move to fire his entire psychiatry staff? Was it an expert panel of mental health professionals or consultants who came in to systematically and objectively evaluate the program based upon interviews and data?

Of course not. It was based upon the opinion of a private attorney’s law firm. Yes, lawyers recommended firing the entire staff. One can only guess as to the rationale, but I’d assume “limiting liability” was near the top of the list.

The firings didn’t just affect the people who worked with the patients. Also fired were two top managers (it’s not clear if this affected all of the managers on the unit or not), the vice president of patient care services and the nurse manager of psychiatry.

The nurses, for their part, say the concerns they had brought to the attention to this same management over the years were largely ignored:

For years the nurses expressed their concerns about the unsafe/unsatisfactory environment and the lack of management leadership. For the most part the nurses were ignored,’’ the letter said.

Which begs the question — if you have caring, devoted staff who are doing the best they can with limited resources, and they bring problems to management, and management largely ignores them, why are you firing the nurses not responsible for the abuse?

Why not simply focus on the staff who are problematic and have a record of performance problems at work? Why not simply focus on the managers and senior executives who failed to listen to their own staff’s recommendations and concerns?

It seems that in an attempt to bring catharsis and clean house, the baby may have been thrown out with the bathwater. Instead of focusing on just the most problematic staffers and managers, the lawyers recommended firing everyone.

The Massachusetts Department of Public Health should consider doing the same to Steward’s Carney Hospital. Fire them, and find a group of competent mental health professionals who can take over the job in a responsible manner that doesn’t require the sacking of an entire hospital unit in order to “fix” abuse problems.

Read the full article: Complaint tally grows at Carney psych unit